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How strontium ranelate, via opposite effects on bone resorption and formation, prevents osteoporosis

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Abstract

Oestrogen deficiency increases the rate of bone remodelling which, in association with a negative remodelling balance (resorption exceeding formation), results in impaired bone architecture, mass and strength. Current anti-osteoporotic drugs act on bone remodelling by inhibiting bone resorption or by promoting its formation. An alternative therapeutic approach is based on the concept of inducing opposite effects on bone resorption and formation. One therapeutic agent, strontium ranelate, was shown to induce opposite effects on bone resorption and formation in pre-clinical studies and to reduce fracture risk in postmenopausal osteoporotic patients. How strontium ranelate acts to improve bone strength in humans remains a matter of debate, however. This review of the most recent pre-clinical and clinical studies is a critical analysis of strontium ranelate’s action on bone resorption and formation and how it increases bone mass, microarchitecture and strength in postmenopausal osteoporotic women.

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Conflicts of interest

PJ Marie received consultancies, speaking fees or honoraria from Servier and Danone. D. Felsenfeld served as scientific advisor, speaker or scientific study support, and ML Brandi received consultancies, speaking fees or honoraria from MSD, P&G, Eli Lilly, Nycomed, Servier, Amgen and Stroder.

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Authors and Affiliations

  1. Laboratory of Osteoblast Biology and Pathology, INSERM, U606, Paris, 75475, France

    P. J. Marie

  2. University Paris Diderot, UMR606, Paris, 75475, France

    P. J. Marie

  3. Centre for Muscle and Bone Research, Charité Campus Benjamin Franklin, Berlin, Germany

    D. Felsenberg

  4. Department of Internal Medicine, University of Florence, Florence, Italy

    M. L. Brandi

  5. Hôpital Lariboisière, INSERM U606, 2 rue Ambroise Paré, 75475, Paris cedex 10, France

    P. J. Marie

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  1. P. J. Marie
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  2. D. Felsenberg
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  3. M. L. Brandi
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Correspondence to P. J. Marie.

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Marie, P.J., Felsenberg, D. & Brandi, M.L. How strontium ranelate, via opposite effects on bone resorption and formation, prevents osteoporosis. Osteoporos Int 22, 1659–1667 (2011). https://doi.org/10.1007/s00198-010-1369-0

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  • DOI: https://doi.org/10.1007/s00198-010-1369-0

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