Strontium ranelate: a novel mode of action leading to renewed bone quality.
Various bone resorption inhibitors and bone stimulators have been shown to decrease the risk of osteoporotic fractures. However, there is still a need for agents promoting bone formation by inducing positive uncoupling between bone formation and bone resorption. In vitro studies have suggested that strontium ranelate enhances osteoblast cell replication and activity. Simultaneously, strontium ranelate dose-dependently inhibits osteoclast activity. In vivo studies indicate that strontium ranelate stimulates bone formation and inhibits bone resorption and prevents bone loss and/or promotes bone gain. This positive uncoupling between bone formation and bone resorption results in bone gain and improvement in bone geometry and microarchitecture, without affecting the intrinsic bone tissue quality. Thus, all the determinants of bone strength are positively influenced. In conclusion, strontium ranelate, a new treatment of postmenopausal osteoporosis, acts through an innovative mode of action, both stimulating bone formation and inhibiting bone resorption, resulting in the rebalancing of bone turnover in favor of bone formation. Strontium ranelate increases bone mass while preserving the bone mineralization process, resulting in improvement in bone strength and bone quality.
Ammann
Patrick
P
Division of Bone Diseases, WHO Collaborating Center for Osteoporosis Prevention, Department of Rehabilitation and Geriatrics, University Hospital of Geneva, 1211 Geneva 14, Switzerland. Patrick.Ammann@hcuge.ch
D015519:Bone Density / Q000187:drug effects; D016723:Bone Remodeling / Q000187:drug effects; D001862:Bone Resorption / Q000517:prevention & control; D001842:Bone and Bones / Q000473:pathology; D005260:Female; D050723:Fractures, Bone / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010024:Osteoporosis / Q000188:drug therapy* / Q000473:pathology; D013268:Stimulation, Chemical; D013876:Thiophenes / Q000627:therapeutic use*; D014475:Uncoupling Agents / Q000627:therapeutic use*
D009942:Organometallic Compounds; D013876:Thiophenes; D014475:Uncoupling Agents; C081587:strontium ranelate