TY - JOUR
T1 - Effects of escitalopram on markers of bone turnover
T2 - A randomized clinical trial
AU - Diem, Susan J.
AU - Joffe, Hadine
AU - Larson, Joseph C.
AU - Tsai, Joy N.
AU - Guthrie, Katherine A.
AU - LaCroix, Andrea Z.
AU - Ensrud, Kristine E.
AU - Freeman, Ellen W.
AU - Leder, Benjamin Z.
N1 - Publisher Copyright:
© 2014 by the Endocrine Society.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Context: Recent observational studies have suggested that the use of selective serotonin reuptake inhibitors is associated with an increased fracture risk and an accelerated bone loss, although conflicting results have been reported. Furthermore, because many of these studies have been performed in depressed women, confounding by indication may influence these findings.Objective:Design: This was a randomized controlled trial.Setting: The study was conducted in four US clinical sites.Participants: Healthy peri- and postmenopausal women participated in the study.Intervention: The intervention was escitalopram (10-20 mg/d) for the treatment of vasomotor symptoms.Main Outcome Measures: Serum carboxyterminal collagen crosslinks (CTX) and serum aminoterminal propeptide of type I collagen (P1NP) were measured.Results: One hundred forty-one peri- or postmenopausal nondepressed women (mean age 53.7 y, SD 4.1) had baseline and 8-week follow-up samples available for analysis and were included in the study (69 escitalopram, 72 placebo). The groups were balanced across a broad range of baseline characteristics, including age, race, body mass index, smoking status, and mood symptoms. The between-group differences in the change in CTX and P1NP from baseline to week 8 were compared by a repeatedmeasures linear regression model adjusted for race, clinical center, and baseline measurement. Treatment with escitalopram reduced serum P1NP by 1.02 ng/mL on average [95% confidence interval (CI) -5.17, 3.12] compared with a reduction of 1.88 ng/mL (95% CI-4.82, 1.06) in the placebo group (P=.65). Similarly, serum CTX decreased 0.02 ng/mL on average (95% CI -0.05, 0.01) in the escitalopram group comparedwith0.00ng/mL(95%CI-0.02,0.02)intheplacebogroup(P=.24).Theresultsweresimilarwhen the analysis was restricted to those women whose adherence to study medication was 70% or greater.Conclusions: Although the study was limited to 8 weeks, these results suggest that escitalopram does not significantly alter bone metabolism in the short term.
AB - Context: Recent observational studies have suggested that the use of selective serotonin reuptake inhibitors is associated with an increased fracture risk and an accelerated bone loss, although conflicting results have been reported. Furthermore, because many of these studies have been performed in depressed women, confounding by indication may influence these findings.Objective:Design: This was a randomized controlled trial.Setting: The study was conducted in four US clinical sites.Participants: Healthy peri- and postmenopausal women participated in the study.Intervention: The intervention was escitalopram (10-20 mg/d) for the treatment of vasomotor symptoms.Main Outcome Measures: Serum carboxyterminal collagen crosslinks (CTX) and serum aminoterminal propeptide of type I collagen (P1NP) were measured.Results: One hundred forty-one peri- or postmenopausal nondepressed women (mean age 53.7 y, SD 4.1) had baseline and 8-week follow-up samples available for analysis and were included in the study (69 escitalopram, 72 placebo). The groups were balanced across a broad range of baseline characteristics, including age, race, body mass index, smoking status, and mood symptoms. The between-group differences in the change in CTX and P1NP from baseline to week 8 were compared by a repeatedmeasures linear regression model adjusted for race, clinical center, and baseline measurement. Treatment with escitalopram reduced serum P1NP by 1.02 ng/mL on average [95% confidence interval (CI) -5.17, 3.12] compared with a reduction of 1.88 ng/mL (95% CI-4.82, 1.06) in the placebo group (P=.65). Similarly, serum CTX decreased 0.02 ng/mL on average (95% CI -0.05, 0.01) in the escitalopram group comparedwith0.00ng/mL(95%CI-0.02,0.02)intheplacebogroup(P=.24).Theresultsweresimilarwhen the analysis was restricted to those women whose adherence to study medication was 70% or greater.Conclusions: Although the study was limited to 8 weeks, these results suggest that escitalopram does not significantly alter bone metabolism in the short term.
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U2 - 10.1210/jc.2014-2288
DO - 10.1210/jc.2014-2288
M3 - Article
C2 - 25014001
AN - SCOPUS:84907193458
SN - 0021-972X
VL - 99
SP - E1732-E1737
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 9
ER -