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Effects of Strontium Ranelate Administration on Calcium Metabolism in Female Patients with Postmenopausal Osteoporosis and Primary Hyperparathyroidism

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Abstract

We investigated possible changes of parameters of calcium metabolism induced by strontium ranelate (SR). Twenty-three patients with postmenopausal osteoporosis (PO) and 14 with primary hyperparathyroidism (PHPT) were studied while taking 2 g/day of SR. Women with PO and 10 healthy age-matched control women were also daily supplemented with 1,000 mg calcium and 800 IU vitamin D. All subjects were studied at baseline and after 7 and 30 days; PO women and controls were also investigated at 180 and 360 days of treatment. Serum ionized calcium (iCa), phosphate (sP), magnesium, creatinine, 25-hydroxycholecalciferol (25[OH]D), 1,25-dihydroxycholecalciferol (1,25[OH]2D), serum parathyroid hormone (PTH) were measured. In spot urine, we assessed calcium and phosphate over creatinine ratios (uCa/Cr, uP/Cr), calcium excretion (Ca ex) and renal phosphate threshold (TmP/GFR); in 24-h urine, calcium and magnesium over creatinine clearance ratios (CaCl/CrCl and MgCl/CrCl). In PO, SR administration was associated with a significant decrease of PTH and 1,25(OH)2D levels but an increase of sP (p < 0.001). SR also significantly increased Ca/Cr, Ca ex, and TmP/GFR in spot urine and CaCl/CrCl in both spot and 24-h urine (p = 0.004 to <0.001). In PHPT, SR significantly decreased iCa and increased sP, slightly modifying PTH, 25(OH)D, and 1,25(OH)2D values. Also in PHPT, Ca ex and CaCl/CrCl of spot and 24-h urine, as TmP/GFR, significantly increased (all p < 0.02). SR influenced the main parameters of calcium homeostasis, probably through the calcium-sensing receptor.

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Authors and Affiliations

  1. Unit of Internal Medicine, “Casa Sollievo della Sofferenza” Hospital, IRCCS, Viale dei Cappuccini snc, 71013, San Giovanni Rotondo, FG, Italy

    Vincenzo Carnevale

  2. Department of Internal Medicine and Medical Specialties, “Sapienza” University, Rome, Policlinico “Umberto I”, Viale del Policlinico 161, 00155, Rome, Italy

    Romano Del Fiacco, Elisabetta Romagnoli, Cristiana Cipriani, Jessica Pepe & Salvatore Minisola

  3. Unit of Biostatistics, “Casa Sollievo della Sofferenza” Hospital, IRCCS, Viale dei Cappuccini snc, 71013, San Giovanni Rotondo, FG, Italy

    Andrea Fontana

Authors
  1. Vincenzo Carnevale
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  2. Romano Del Fiacco
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  3. Elisabetta Romagnoli
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  4. Andrea Fontana
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  5. Cristiana Cipriani
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  6. Jessica Pepe
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  7. Salvatore Minisola
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Correspondence to Vincenzo Carnevale.

Additional information

Vincenzo Carnevale and Romano Del Fiacco contributed equally to this study.

The authors have stated that they have no conflict of interest. Dr. Romano Del Fiacco is currently employed in Eli Lilly-Italy, but he participated in the study before his employment with this company.

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Carnevale, V., Del Fiacco, R., Romagnoli, E. et al. Effects of Strontium Ranelate Administration on Calcium Metabolism in Female Patients with Postmenopausal Osteoporosis and Primary Hyperparathyroidism. Calcif Tissue Int 92, 15–22 (2013). https://doi.org/10.1007/s00223-012-9659-5

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  • DOI: https://doi.org/10.1007/s00223-012-9659-5

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