Effects of long-term strontium ranelate treatment on vertebral fracture risk in postmenopausal women with osteoporosis

Abstract

Summary Vertebral fractures are a major adverse consequence of osteoporosis. In a large placebo-controlled trial in postmenopausal women with osteoporosis, strontium ranelate reduced vertebral fracture risk by 33% over 4 years, confirming the role of strontium ranelate as an effective long-term treatment in osteoporosis. Introduction Osteoporotic vertebral fractures are associated with increased mortality, morbidity, and loss of quality-oflife (QoL). Strontium ranelate (2 g/day) was shown to Osteoporos Int (2009) 20:1663-1673 DOI 10.1007 prevent bone loss, increase bone strength, and reduce vertebral and peripheral fractures. The preplanned aim of this study was to evaluate long-term efficacy and safety of strontium ranelate. Methods A total of 1,649 postmenopausal osteoporotic women were randomized to strontium ranelate or placebo for 4 years, followed by a 1-year treatment-switch period for half of the patients. Primary efficacy criterion was incidence of patients with new vertebral fractures over 4 years. Lumbar bone mineral density (BMD) and QoL were also evaluated. Results Over 4 years, risk of vertebral fracture was reduced by 33% with strontium ranelate (risk reduction=0.67, p< 0.001). Among patients with two or more prevalent vertebral fractures, risk reduction was 36% (p<0.001). QoL, assessed by the QUALIOST®, was significantly better (p=0.025), and patients without back pain were greater (p=0.005) with strontium ranelate than placebo over 4 years. Lumbar BMD increased over 5 years in patients who continued with strontium ranelate, while it decreased in patients who switched to placebo. Emergent adverse events were similar between groups. Conclusion In this 4-and 5-year study, strontium ranelate is an effective and safe treatment for long-term treatment of osteoporosis in postmenopausal women.

Agonists and Allosteric Modulators of the Calcium-Sensing Receptor and Their Therapeutic Applications

“…In addition, in patients above the age of 74 years, the incidence of nonvertebral fractures was 16% lower in the strontium ranelate-treated group compared with the placebo group, and the risk of hip fractures diminished by 36% (Tournis et al, 2006). Furthermore, recent long-term studies (8 and 5 years) have reported a continued increase in bone mass density in strontium ranelate treated postmenopausal women and a reduced risk of fractures (Meunier et al, 2009;Reginster et al, 2009). …”

An Akt-dependent Increase in Canonical Wnt Signaling and a Decrease in Sclerostin Protein Levels Are Involved in Strontium Ranelate-induced Osteogenic Effects in Human Osteoblasts

“…Strontium ranelate is a treatment for osteoporosis that decreases the incidence of vertebral and femoral fracture risk in postmenopausal women (1)(2)(3). Strontium ranelate has been shown to modulate the physiological processes of bone formation and bone resorption (2), resulting in increased bone apposition rates (3) and bone mineral density (1, 2, 4 -6), while maintaining the quality of bone mineral (6).…”

Histopathological evaluation of the effect of locally administered strontium on healing time in mandibular fractures: An experimental study

“…6 Awareness of the biological role of strontium has increased in recent years. 11,12 Physiological bone regeneration, a coordinated process, is maintained by boneforming osteoblasts and bone-resorbing osteoclasts. The 2 factors produced by osteoblasts forming the bone: receptor activator NF-κB ligand (RANKL) and osteoprotegerin (OPG) control the activity and differentiation of osteoclasts.…”