Osteoporosis International

, Volume 16, Supplement 1, pp S4–S6 | Cite as

Prevention of vertebral fractures by strontium ranelate in postmenopausal women with osteoporosis

Original Article


The antifracture efficacy of strontium ranelate, a compound with a novel mechanism of action on bone, has been assessed in two large, randomized, controlled trials conducted in postmenopausal women. Strontium ranelate was given at a daily dose of 2 g, and all women received calcium and vitamin D supplements. In women with established osteoporosis there was a 41% reduction in vertebral fractures over 3 years’ treatment [relative risk (RR) 0.59; 95% confidence interval (CI) 0.48–0.73; P<0.001]; significant reductions were also seen after only 1 year of treatment. The beneficial effect was also seen for clinical vertebral fractures: over 3 years there was a significant reduction in new clinical vertebral fractures (RR 0.62; 95% CI 0.47–0.83; P<0.001); this reduction was also observed during the first year of treatment (RR 0.48; 95% CI 0.29–0.80; P=0.003). Over the 3-year treatment period significantly fewer patients had height loss and fewer patients reported new or worsening back pain in the treated group than in the control group. These results demonstrate that strontium ranelate is a new therapeutic option in the prevention of osteoporotic vertebral fractures in postmenopausal women.


Postmenopausal osteoporosis Strontium ranelate Vertebral fracture 


  1. 1.
    Boivin G, Deloffre P, Perrat B, Panczer G, Boudeulle M, Tsouderos Y, et al (1996) Strontium distribution and interactions with bone mineral in monkey iliac bone after strontium salt (S12911) administration. J Bone Miner Res 11:1302-1311PubMedGoogle Scholar
  2. 2.
    Su Y, Bonnet J, Deloffre P, Tsouderos Y, Baron R (1992) The strontium salt S12911 inhibits bone resorption in mouse calvaria and isolated rat osteoclast cultures. Bone Miner 17 [Suppl]:188Google Scholar
  3. 3.
    Canalis E, Hott M, Deloffre P, Tsouderos Y, Marie PJ (1996) The divalent strontium salt S12911 enhances bone cell replication and bone formation in vitro. Bone 18:517–523CrossRefPubMedGoogle Scholar
  4. 4.
    Marie PJ, Hott M, Modrowski D, de Pollak C, Guillemain J, Deloffre P, et al (1993) An uncoupling agent containing strontium prevents bone loss by depressing bone resorption and maintaining bone formation in estrogen-deficient rats. J Bone Miner Res 8:607–615PubMedGoogle Scholar
  5. 5.
    Buehler J, Chappuis P, Saffar JL, Tsouderos Y, Vignery A (2001) Strontium ranelate inhibits bone resorption while maintaining bone formation in alveolar bone in monkeys (Macaca fascicularis). Bone 29:176–179CrossRefPubMedGoogle Scholar
  6. 6.
    Meunier PJ, Slosman DO, Delmas PD, Sebert JL, Brandi ML, Albanese C, et al (2002) Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis—a 2-year randomised placebo controlled trial. J Clin Endocrinol Metab 87:2060–2066CrossRefPubMedGoogle Scholar
  7. 7.
    Meunier PJ, Roux C, Seeman E, Ortolani S, Badurski JE, Spector TD, et al (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459–468CrossRefPubMedGoogle Scholar
  8. 8.
    Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 9:1137–1148Google Scholar
  9. 9.
    Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, et al (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541CrossRefPubMedGoogle Scholar
  10. 10.
    Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, et al (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis. A randomized controlled trial. JAMA 282:1344–1352CrossRefPubMedGoogle Scholar
  11. 11.
    Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, et al (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. JAMA 282:637–645CrossRefPubMedGoogle Scholar
  12. 12.
    Reginster J-Y, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, et al (2000) Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Osteoporos Int 11:83–91CrossRefPubMedGoogle Scholar
  13. 13.
    Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster J-Y, et al (2001) Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 344:1434–1441CrossRefPubMedGoogle Scholar
  14. 14.
    Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD (1993) Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black osteoporotic women. Osteoporos Int 3:120–126PubMedGoogle Scholar
  15. 15.
    Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA III, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739PubMedGoogle Scholar
  16. 16.
    Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323CrossRefPubMedGoogle Scholar
  17. 17.
    Maricic M, Adachi JD, Sarkar S, Wu W, Wong M, Harper KD (2002) Early effects of raloxifene on clinical vertebral fractures at 12 months in postmenopausal women. Arch Intern Med 162:1140–1143CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  1. 1.Department of Medicine, Box 157Addenbrooke’s HospitalCambridgeUK
  2. 2.Department of MedicineUniversity of Cambridge School of Clinical MedicineCambridgeUK

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