Strontium Ranelate Group Research Articles

Strontium ranelate reduces the urinary level of cartilage degradation biomarker CTX-II in postmenopausal women

Objective Strontium ranelate significantly decreases the risk of osteoporotic fractures. The objective of the present study was to investigate whether strontium ranelate (2 g/day) also affects cartilage brakedown as measured by urinary marker of cartilage degradation, designated CTX-II. Methods A subgroup of 2617 postmenopausal osteoporotic women (aged 75.7 ± 4.4 years) were selected from the TROPOS phase III study on the basis of a urinary sampling reported at each visit during the first three years of the study. When included in TROPOS, they were randomized to strontium ranelate or placebo in a double-blind fashion for 3 years. A calcium and vitamin D supplement was also provided to the subjects during the study. A marker of collagen type II degradation (CTX-II) corrected for urinary creatinine (CTX-II/cr.) was assessed at regular intervals throughout the study in 1310 patients in strontium ranelate group and 1307 patients in placebo group. Results The response in CTX-II depended on time ( p < 0.0001), and this time dependency differed statistically significantly between groups (time × treatment) ( p < 0.0003). In addition, there was a statistically significant difference between treatments ( p < 0.0001). The difference in the response of CTX-II/cr. appeared already after three months, with the strontium ranelate-treated subjects having approximately 15–20% lower values than the placebo-treated subjects for the remaining study period ( p < 0.0001). Conclusion Treatment with strontium ranelate significantly decreases urinary excretion of CTX-II, a marker of cartilage destruction. Further studies are warranted to investigate an effect on cartilage formation and symptoms of osteoarthritis.

Strontium ranelate: An increased bone quality leading to vertebral antifracture efficacy at all stages

Strontium ranelate is a new antiosteoporotic treatment with a dual mode of action, both increasing bone formation and decreasing bone resorption, which rebalances bone turnover in favor of bone formation and increases bone strength. The antifracture efficacy of strontium ranelate, 2 g per day orally, in the treatment of postmenopausal osteoporosis has been investigated in a large-scale, international, multicenter, phase 3 program in which more than 7000 patients were recruited. This article deals with the vertebral antifracture efficacy of strontium ranelate in postmenopausal women with osteoporosis. A significant early (after 1 year) and sustained (over 3 years) antifracture efficacy of strontium ranelate, compared with placebo, was demonstrated in patients with prevalent vertebral fracture with reductions in risk of new vertebral fracture of 49% after 1 year ( P < 0.001) and 41% over 3 years ( P < 0.001). In addition, the relative risk of clinical vertebral fracture was significantly reduced by 52% ( P = 0.003) after 1 year and by 38% ( P < 0.001) over 3 years in the strontium ranelate group compared with placebo. Strontium ranelate was also demonstrated to significantly decrease the relative risk of vertebral fractures by 45% ( P < 0.001) in patients without prevalent vertebral fracture over 3 years, vs. placebo. Bone mineral density was linearly increased during 3 years of treatment with strontium ranelate in comparison with placebo. Strontium ranelate was well tolerated throughout the entire duration of the clinical trials. Thus, strontium ranelate, 2 g per day orally, is a new, effective, and safe treatment for postmenopausal patients with osteoporosis, to reduce the vertebral fracture risk in patients with or without a history of vertebral fracture.

Clinical effects of strontium ranelate in women with postmenopausal osteoporosis

Postmenopausal osteoporosis has long-term physical, psychological, and social consequences with a major impact on patients' daily life. Treatment for such a chronic disease needs to be clinically effective and well tolerated, and should ultimately result in a beneficial effect on quality of life. The antifracture efficacy of strontium ranelate, 2 g/day orally, an agent that appears to have dissociation effects on resorption and formation, has been assessed in two large, randomized, double-blind, placebo-controlled clinical studies: the Spinal Osteoporosis Therapeutic Intervention (SOTI) trial and the TReatment Of Peripheral Osteoporosis Study (TROPOS), including more than 6,700 postmenopausal women. Pending the results of TROPOS, a 3-year analysis of SOTI results shows that strontium ranelate significantly reduces new vertebral and clinical vertebral fracture incidence in postmenopausal osteoporotic women. This significant reduction in the risk of clinical and new vertebral fractures has been demonstrated as early as after 1 year of treatment (RR = 0.48, p = 0.003; and RR = 0.51, p < 0.001, respectively) and is maintained over 3 years (RR = 0.62, p < 0.001; and RR = 0.59, p < 0.001, respectively). This is accompanied by decreased back pain and body height loss in the strontium ranelate group compared with the placebo group. As strontium ranelate appears to improve clinical signs and is, furthermore, well tolerated especially in the upper gastrointestinal region, this treatment is expected to result in an improved health-related quality of life (HRQoL). Strontium ranelate thus offers significant clinical benefits in terms of efficacy, tolerability, and ease of administration in the treatment of postmenopausal women with vertebral osteoporotic fractures.