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Strontium ranelate: A new treatment for postmenopausal osteoporosis with a dual mode of action

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Abstract

In vitro, strontium ranelate increases collagen and noncollagen protein synthesis by mature osteoblast-enriched cells. Its effects on bone formation were confirmed as the drug enhanced preosteoblastic cell replication. In the isolated osteoclast, preincubation of bone slices with strontium ranelate-induced dose-dependent inhibition of the bone-resorbing activity of treated rat osteoclast. Strontium ranelate dose-dependently inhibited preosteoclast differentiation. Its effect in postmenopausal women with established osteoporosis was assessed during an international, prospective, double-blind, randomized, placebo-controlled phase 3 program comparing strontium ranelate 2 g daily with placebo. The 3-year analysis of the phase 3 study, Spinal Osteoporosis Therapeutic Intervention, evaluating the effect of strontium ranelate 2 g/day on vertebral fracture rates, revealed a significant 41% reduction in the relative risk of patients experiencing new vertebral fracture with strontium ranelate over 3 years. A second phase 3 study showed a significant reduction in the relative risk of experiencing a nonvertebral fracture in the group treated with strontium ranelate over 3 years. These results show that strontium ranelate is a new, effective, and safe treatment for vertebral and hip osteoporosis, with a unique mode of action, increasing bone formation and decreasing bone resorption leading to a rebalance of bone turnover in favor of bone formation.

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References and Recommended Reading

  1. Canalis E, Hott M, Deloffre P, et al.: The divalent strontium salt S12911 enhances bone cell replication and bone formation in vitro. Bone 1996, 18:517–523.

    Article  PubMed  CAS  Google Scholar 

  2. Marie PJ, Ammann P, Boivin G, Rey C: Mechanisms of action and therapeutic potential of strontium in bone. Calcif Tissue Int 2001, 69:121–129.

    Article  PubMed  CAS  Google Scholar 

  3. Izumisawa T, Morohashi T, Amano H, Yamada S: The effect of stable strontium on calcium metabolism: II. Effect of 1-hydroxyvitamin D3 in strontium-fed rats and inhibitory effect of strontium on bone resorption in vitro. J Bone Miner Metab 1994, 12:43–49.

    Article  CAS  Google Scholar 

  4. Takahashi N, Sasaki T, Tsouderos Y, Suda T: S12911-2 inhibits osteoclastic bone resorption in vitro. J Bone Miner Res 2003, 18:1082–1087.

    Article  PubMed  CAS  Google Scholar 

  5. Baron R, Tsouderos Y: In vitro effects of S12911-2 on osteo-clast function and bone marrow macrophage differentiation. Eur J Pharmacol 2002, 450:11–17.

    Article  PubMed  CAS  Google Scholar 

  6. Buehler J, Chappuis P, Saffar JL, et al.: Strontium ranelate inhibits bone resorption while maintaining bone formation in alveolar bone in monkeys (Macaca fascicularis). Bone 2001, 29:176–179.

    Article  PubMed  CAS  Google Scholar 

  7. Boivin G, Deloffre P, Perrat B, et al.: Strontium distribution and interactions with bone mineral density in monkey iliac bone after strontium salt (S12911) administration. J Bone Miner Res 1996, 11:1302–1311.

    PubMed  CAS  Google Scholar 

  8. Morohashi T, Sano T, Harai K, Yamada S: Effects of strontium on calcium metabolism in rats II. Strontium prevents the increased rate of bone turnover in ovariectomized rats. Jpn J Pharmacol 1995, 68:153–159.

    PubMed  CAS  Google Scholar 

  9. Marie PJ, Hott M, Modrowski D, et al.: An uncoupling agent containing strontium prevents bone loss by depressing bone resorption and maintining bone formation in estrogen-deficient rats. J Bone Miner Res 1993, 8:607–615.

    PubMed  CAS  Google Scholar 

  10. Hott M, Deloffre P, Tsouderos Y, Marie PJ: S12911-2 reduces bone loss induced by short-term immobilization in rats. Bone 2003, 33:115–123.

    Article  PubMed  CAS  Google Scholar 

  11. Meunier PJ, Slosman D, Delmas P, et al.: Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis: a 2-year randomized placebo controlled trial. J Clin Endocrinol Metab 2002, 87:2060–2066. The first trial showing an effect on strontium ranelate on BMD and biochemical markers of bone turnover in postmenopausal women.

    Article  PubMed  CAS  Google Scholar 

  12. Boivin G, Foos E, Tupinon-Mathieu I, Meunier PJ: Strontium deposition in bone is dose dependent and does not alter the degree of mineralization of bone in osteoporotic patients treated with strontium ranelate. J Bone Miner Res 2000, 15(Suppl 1):305.

    Google Scholar 

  13. Reginster JY, Diez-Perez A, Ortolani S, et al.: Calcium-vitamin D supplementation in clinical trials of osteoporosis should be titrated on the basis of pre-study assessments. Osteoporos Int 2002, 13(Suppl 1):S24.

    Google Scholar 

  14. Reginster JY, Spector T, Badurski J, et al.: A short-term run-in study can significantly contribute to increasing the quality of long-term osteoporosis trials. The strontium ranelate Phase III program. Osteoporos Int 2002, 13(Suppl 1):S30.

    Google Scholar 

  15. Genant HK, Wu CY, Van Kuijk C, Newit MC: Vertebral semi quantitative assessment using a semi-quantitative technique. J Bone Miner Res 1993, 8:1137–1148.

    Article  PubMed  CAS  Google Scholar 

  16. Meunier PJ, Roux Ortolani S, et al.: Strontium ranelate reduces the vertebral fracture risk in women with postmenopausal osteoporosis. Osteoporos Int 2002, 13(Suppl 1):O45.

    Google Scholar 

  17. Meunier PJ, Roux Seeman E, et al.: The effect of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004, 350:459–468. A prospective double-blind randomized study demonstrating the antifracture efficacy of strontium ranelate, in spinal osteoporosis in postmenopausal women.

    Article  PubMed  CAS  Google Scholar 

  18. Rizzoli R, Reginster JY, Diaz-Curiel M, et al.: Patients at high risk of hip fracture benefit from treatment with strontium ranelate. Osteoporos Int 2004, 15(Suppl 1):OC39.

    Google Scholar 

  19. Reginster JY, Rizzoli R, Balogh A, et al.: Strontium ranelate reduces the risk of vertebral fractures in osteoporotic post menopausal women without prevalent vertebral fracture. Calcif Tissue Int 2004, 74(Suppl 1):P151.

    Google Scholar 

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Authors and Affiliations

  1. Bone and Cartilage Metabolism Research Unit, CHU Centre-Ville, Policliniques L. BRULL, Quai Godefroid Kurth 45 (9ème étage), 4020, Liege, Belgium

    Jean-Yves Reginster MD, PhD

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  1. Jean-Yves Reginster MD, PhD
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  2. Nathalie Sarlet MD
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  3. Eric Lejeune MSc
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  4. Lorenzo Leonori MSc
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Reginster, JY., Sarlet, N., Lejeune, E. et al. Strontium ranelate: A new treatment for postmenopausal osteoporosis with a dual mode of action. Curr Osteoporos Rep 3, 30–34 (2005). https://doi.org/10.1007/s11914-005-0025-7

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  • DOI: https://doi.org/10.1007/s11914-005-0025-7

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