Abstract
Osteoporosis is a systemic skeletal disease responsible for the high incidence of fractures in older subjects, particularly in postmenopausal women. The increasing prevalence with population ageing and prolonged life expectancy raises the rates of associated morbidity, loss of independence, and mortality. BMD and previous fracture history are two main risk factors associated with osteoporosis such that the presence of prior fractures can predict future fractures. Strontium ranelate is an agent developed for the management of postmenopausal osteoporosis, demonstrated to reduce vertebral, nonvertebral, major nonvertebral, and hip fractures. It has been demonstrated to be effective for a broad spectrum of patients, including women with osteopenia, osteoporosis, and severe disease.
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References
Siris S, Miller PD, Barrett-Connor E (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822
Consensus development conference (1993) Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94(6):646–650
Cooper C, Atkinson EJ, O'Fallon WM, Melton LJ 3rd (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7(2):221–227
Cooper (1997) The crippling consequences of fractures and their impact on quality of life. AM J Med 103(2):12S–19S
Manolagas SC (2000) Birth and death of bone cells: basic regulatory mechanisms and implications for the pathogenesis and treatment of osteoporosis. Endocr Rev 21:115–137
Kanis JA, and the WHO Study Group (1994) Assessment of fracture risk and its application to screening for post-menopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 4:368–381
Kanis JA, Melton LJ III, Christiansen C et al (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141
US Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the surgeon general. Rockville, MD
van StaaTP D, EM LHG, Cooper C (2001) Epidemiology of fractures in Wales and England. Bone 29:517–522
Cooper C, Harvey N, Dennison E (2008) Worldwide epidemiology of osteoporotic fractures. In innovation in skeletal medicine: 95–112. Rizzoli and Reginster ed
Cooper C, Atkinson EJ, Kotowicz M, O'Fallon WM, Melton LJ 3rd (1992) Secular trends in the incidence of postmenopausal vertebral fractures. Calcif Tissue Int 51(2):100–104
Dempster DW (2006) Anatomy and functions of the adult skeleton. In: Favus MJ, et al, eds. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 6th ed. Washington, DC: American Society for Bone and Mineral Research:7-11
Chrischilles EA, Butler CD, Davis CS, Wallace RB (1991) A model of lifetime osteoporosis impact. Arch Intern Med 151:2026–2032
Lindsay R, Silverman S, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323
Brown SA, Rosen CJ (2003) Osteoporosis. Med Clin North Am 87:1039–1063
Kanis JA, McCloskey EV, Johansson H, Strom O, Borgstrom F, Oden A, National Osteoporosis Guideline Group (2008) Case finding for the management of osteoporosis with FRAX—assessment and intervention thresholds for the UK. Osteoporos Int 19(10):1395–1408
available on www.shef.ac.uk/FRAX
Sandhu SK, Nguyen ND, Center JR, Pocock NA, Eisman JA, Nguyen TV (2010) Prognosis of fracture: evaluation of predictive accuracy of the FRAX algorithm and Garvan nomogram. Osteoporos Int 21(5):863–871
Hosoi T, WHO FRAX(R) (2009) Usefulness and limitation of FRAX(R) in the practice of internal medicine. Clin Calcium 19(12):1749–1755
Seeman E, Devogelaer JP, Lorenc R et al (2008) Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia. J Bone Miner Res 23(3):433–438
Meunier PJ, Roux C, Seeman E et al (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Eng J Med 350(5):459–468
Reginster JY, Seeman E, de Vernejoul MC et al (2005) Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: treatment of peripheral osteoporosis (TROPOS) study. J Clin Endocrinol Metab 90:2816–2822
Roux C, Reginster JY, Fechtenbaum J et al (2006) Vertebral fracture risk reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors. J Bone Miner Res 21(4):536–542
Bruyère O, Roux C, Badurski J et al (2007) Relationship between change in femoral neck bone mineral density and hip fracture incidence during treatment with strontium ranelate. Curr Med Res Opin 23(12):3041–3045
Reginster JY, Sarlet N, Lejeune E, Leonori L (2005) Strontium ranelate: a new treatment for postmenopausal osteoporosis with a dual mode of action. Curr Osteoporos Rep 3(1):30–34
Marie PJ (2005) Strontium ranelate: a novel mode of action optimizing bone formation and resorption. Osteoporos Int Suppl 1:S7–S10
Marie PJ (2006) Strontium ranelate: a dual mode of action rebalancing bone turnover in favour of bone formation. Curr Opin Rheumatol Suppl 1:S11–S15
Brennan TC, Rybchyn MS, Green W et al (2009) Osteoblasts play key roles in the mechanisms of action of strontium ranelate. Br J Pharmacol 157(7):1291–1300
Neuprez A, Hiligsmann M, Scholtissen S, Bruyere O, Reginster JY (2008) Strontium ranelate: the first agent of a new therapeutic class in osteoporosis. Adv Ther 25(12):1235–1256
Ammann P, Shen V, Robin B et al (2004) Strontium ranelate improves bone resistance by increasing bone mass and improving architecture in intact female rats. J Bone Miner Res 19:2012–2020
Recker R, Marin F, Ish-Shalom S et al (2009) Comparative effects of teriparatide and strontium ranelate on bone biopsies and biochemical markers of bone turnover in postmenopausal women with osteoporosis. J Bone Miner Res 24(8):1358–1368
Kendler DL, Adachi JD, Josse RG, Slosman DO (2009) Monitoring strontium ranelate therapy in patients with osteoporosis. Osteoporos Int 20(7):1101–1106
Sarkar S, Mitlak BH, Wong M, Stock JL, Black DM, Harper KD (2002) Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy. J Bone Miner Res 17(1):1–10
Watts NB, Geusens P, Barton IP, Felsenberg D (2005) Relationship between changes in BMD and nonvertebral fracture incidence associated with risedronate: reduction in risk of nonvertebral fracture is not related to change in BMD. J Bone Miner Res 20:2097–2104
Cummings SR, Karpf DB, Harris F, Genant HK, Ensrud K, LaCroix AZ, Black DM (2002) Improvement in spine bone density and reduction in risk of vertebral fractures during treatment antiresorptive drugs. Am J Med 112(4):281–289
Delmas P, Seeman E (2004) Changes in bone mineral density explain little of the reduction in vertebral or nonvertebral fracture risk with anti-resorptive therapy. Bone 34:599–604
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C.C. performs consulting and lecturing with Servier, MSD, Lilly, Alliance, Amgen, and Novartis.
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Cooper, C. Osteoporosis: disease severity and consequent fracture management. Osteoporos Int 21 (Suppl 2), 425–429 (2010). https://doi.org/10.1007/s00198-010-1251-0
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DOI: https://doi.org/10.1007/s00198-010-1251-0