Journal of Bone and Mineral Metabolism

, Volume 34, Issue 5, pp 540–546 | Cite as

Effects of strontium ranelate on bone mass and bone turnover in women with thalassemia major-related osteoporosis

  • Nunziata Morabito
  • Antonino CatalanoEmail author
  • Agostino Gaudio
  • Elisabetta Morini
  • Lucia Maria Bruno
  • Giorgio Basile
  • Eleni Tsiantouli
  • Federica Bellone
  • Rita Maria Agostino
  • Basilia Piraino
  • Maria Angela La Rosa
  • Carmelo Salpietro
  • Antonino Lasco
Original Article


Subjects affected by thalassemia major (TM) often have reduced bone mass and increased fracture risk. Strontium ranelate (SrR) is an effective treatment for postmenopausal and male osteoporosis. To date, no data exist on the use of SrR in the treatment of TM-related osteoporosis. Our aim was to evaluate the effects of SrR on bone mineral density (BMD), bone turnover markers and inhibitors of Wnt signaling (sclerostin and DKK-1). Twenty-four TM osteoporotic women were randomized to receive daily SrR 2 g or placebo in addition to calcium carbonate (1,000 mg) and vitamin D (800 IU). BMD at the lumbar spine and femoral neck, bone turnover markers (C-terminal telopeptide of procollagen type I [CTX], bone-specific alkaline phosphatase [BSAP]) and insulin-like growth factor-1 (IGF-1), sclerostin and DKK-1 were assessed at baseline and after 24 months. Back pain was measured by visual analog scale (VAS) every 6 months. After 24 months, TM women treated with SrR had increased their spine BMD values in comparison to baseline (p < 0.05). Moreover, they also exhibited a reduction of CTX and sclerostin levels (but not DKK-1) and exhibited an increase of BSAP and IGF-1 (p < 0.05); however, no significant changes were observed in the placebo group. In the SrR group, a reduction of back pain was observed after 18 months in comparison to baseline (p < 0.05) and after 24 months in comparison to placebo (p < 0.05). Our study reports for the first time the effects of SrR in the treatment of TM-related osteoporosis. SrR treatment improved BMD and normalized bone turnover markers, as well as lowering sclerostin serum levels.


Thalassemia Osteoporosis DKK-1 Strontium ranelate Sclerostin 



We would like to thank Dr. Corrado Andrè for DXA assessment of subjects involved in this research study.

Conflict of Interest

Nunziata Morabito, Antonino Catalano, Agostino Gaudio, Elisabetta Morini, Lucia Maria Bruno, Giorgio Basile, Eleni Tsiantouli, Federica Bellone, Rita Maria Agostino, Basilia Piraino, Maria Angela La Rosa, Carmelo Salpietro and Antonino Lasco declare that they have no conflict of interest.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2015

Authors and Affiliations

  • Nunziata Morabito
    • 1
  • Antonino Catalano
    • 1
    Email author
  • Agostino Gaudio
    • 2
  • Elisabetta Morini
    • 1
  • Lucia Maria Bruno
    • 1
  • Giorgio Basile
    • 1
  • Eleni Tsiantouli
    • 1
  • Federica Bellone
    • 1
  • Rita Maria Agostino
    • 3
  • Basilia Piraino
    • 4
  • Maria Angela La Rosa
    • 4
  • Carmelo Salpietro
    • 4
  • Antonino Lasco
    • 1
  1. 1.Department of Clinical and Experimental MedicineUniversity Hospital of MessinaMessinaItaly
  2. 2.Department of Medical and Pediatric SciencesUniversity of CataniaCataniaItaly
  3. 3.Department of Human PathologyUniversity of MessinaMessinaItaly
  4. 4.Department of Pediatric SciencesUniversity Hospital of MessinaMessinaItaly

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