Ibandronate Increases Sclerostin Levels and Bone Strength in Male Patients with Idiopathic Osteoporosis

Christian Muschitz*, Roland Kocijan, Dieter Pahr, Janina M. Patsch, Karin Amrein, Barbara M. Misof, Alexandra Kaider, Heinrich Resch, Peter Pietschmann

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Journal article

13 Citations (Scopus)


The pathomechanism of male idiopathic osteoporosis (MIO) differs from postmenopausal osteoporosis with regard to alterations in osteoblast activity. We evaluated intravenous ibandronate (IBN) in 25 MIO patients with fragility fractures in a prospective, monocentric, single-arm, and open-label study for 24 months. The impact and changes of sclerostin (Scl), Dickkopf-1 (DKK-1), CTX, and PINP were examined. Additionally, volumetric cortical, trabecular and areal bone mineral density (BMD), trabecular bone score (TBS), and finite element analyses (FEA) were evaluated. Compared to baseline, median Scl levels were increased after 1 month (Δ 121 %, p < 0.0001) and remained elevated for 12 months. DKK-1 decreased (p < 0.001) to a lesser extent until month 9 with values comparable to baseline at study endpoint. Early changes (baseline–month 1) of Scl negatively correlated with early changes of DKK-1 (−0.72), CTX (−0.82), and PINP (−0.55; p < 0.005 for all). The overall changes over the 24 months study period of Scl negatively correlated with decreased CTX (−0.32) and DKK-1 levels (−0.57, p < 0.0001 for both); CTX and PINP changes positively correlated at each time point (p < 0.001). Volumetric hip BMD increased by 12 and 18 %, respectively (p < 0.0001 for both). Cross-sectional moment of inertia and section modulus for total hip significantly improved (p < 0.05 for all). Areal BMD at total hip, spine, and TBS increased. FEA displayed an increase in bone strength both in the hip (17 %) and vertebrae (13 %, all p < 0.0001) at anatomical sites susceptible for fragility fracture. IBN increases Scl and improves cortical and trabecular bone strength with early and ongoing vigorous suppression of bone resorption.

Original languageEnglish
Article number3
Pages (from-to)477-489
Number of pages13
JournalCalcified Tissue International
Issue number6
Publication statusPublished - 26 Jun 2015
Externally publishedYes


  • Antiresorptive agents
  • Bone turnover marker
  • Finite element analysis
  • Ibandronate
  • Male osteoporosis
  • Sclerostin

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology


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