Original Article

Osteoporosis International

, Volume 20, Issue 10, pp 1663-1673

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

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

  • P. J. MeunierAffiliated withFaculty Laennec, Claude Bernard University Email author 
  • , C. RouxAffiliated withService de Rhumatologie B, Université Paris Descartes, Hôpital Cochin
  • , S. OrtolaniAffiliated withDivisione di Endocrinologia, Istituto Auxologico Italiano
  • , M. Diaz-CurielAffiliated withServicio de Medicina Interna, Fundación Jiménez Diaz
  • , J. CompstonAffiliated withDepartment of Medicine, University of Cambridge, Addenbrooke’s Hospital
  • , P. MarquisAffiliated withMAPI Values
  • , C. CormierAffiliated withService de Rhumatologie A, Hôpital Cochin, AP-HP Universite Paris Descartes, Faculte De Medecine, Service de densitométrie Osseuse
  • , G. IsaiaAffiliated withDipartimento Medicina Interna, Consultant, Università degli Studi Torino
  • , J. BadurskiAffiliated withDepartment of Medicine & Rheumatology, Center of Osteoporosis and Osteo-articular Diseases
    • , J. D. WarkAffiliated withDepartment of Medicine, Royal Melbourne Hospital
    • , J. ColletteAffiliated withService de Chimie Médicale, Centre Hospitalier Universitaire de Liège
    • , J. Y. ReginsterAffiliated withUnité Exploration du Métabolisme Osseux, CHU Brull



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.


Osteoporotic vertebral fractures are associated with increased mortality, morbidity, and loss of quality-of-life (QoL). Strontium ranelate (2 g/day) was shown to 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.


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.


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.


In this 4- and 5-year study, strontium ranelate is an effective and safe treatment for long-term treatment of osteoporosis in postmenopausal women.


Bone densitometry Menopause Osteoporotic fracture Osteoporosis treatment Strontium ranelate