HRQCT-based FEA was used to estimate the effects of treatment Z VAD FMK on bone strength and stiffness at T12 using the technique described by Graeff et al. [38]. Digital finite

element models were generated for each patient from the segmented HRQCT images at an isometric resolution of 1.3 mm. The superior and inferior endplates were embedded in a thin layer of polymethyl-methacrylate (PMMA) and the mineral density of each voxel/element was converted to bone volume fraction (BV/TV) with a calibration equation assuming a homogeneous tissue density. The bone tissue material behaviour was elastoplastic with damage; that is, irreversible strains develop and elastic modulus degrades with post-yield loading history. The model generation procedure and bone material properties have been described in detail by Chevalier et al. [39]. To account for a broad spectrum of physiological loading, the FEAs of each vertebral body included axial compression, anterior bending and axial torsion. The structural output variables computed by the FEAs were axial stiffness (kN/mm) and maximal load (kN) for axial compression, and angular stiffness (kN mm/rad) and maximal torque (kN mm) for anterior bending and axial torsion. A normalized strength in axial compression (N/mm2 = MPa) was also calculated MCC950 supplier as strength divided by the central cross-sectional area of the entire

vertebral body. All personnel

in the radiology departments of the study sites were blinded to treatment assignment to reduce any potential bias from the open-label study design. Likewise, all scans were assessed centrally by radiology readers and engineers blinded to treatment assignment. Statistical VAV2 analysis This was a pre-planned analysis of the EuroGIOPs clinical trial. All randomized patients who received at least one dose of study medication were included in the analyses. A mixed-model of repeated measures (MMRM) was used to analyse between-group differences and within- group changes by modelling the changes from baseline in BTM and FEA parameters. The model included terms for baseline value, treatment, visit, interaction between treatment and visit, age, baseline PINP, fracture within 12 months prior to study (yes/no), duration of bisphosphonate use, baseline GC dose, and cumulative GC doses before and during the study (fixed effects). Patients nested within treatment were included as random effects. Within the treatment groups, adjusted means obtained after controlling for the covariates (least square means [LS means]) with click here standard errors were derived at each of the follow-up visits. For differences between treatment groups, p values were derived and are presented in the results. The p values for the within group changes from baseline were derived and are indicated in the results when p < 0.05.