title: Short-term hemostatic safety of strontium ranelate treatment in elderly women with osteoporosis.
abstract: BACKGROUND
  Strontium ranelate offers significant clinical benefits in terms of efficacy, tolerability, and ease of administration in the treatment of postmenopausal osteoporosis. However, there are some data revealing an association between strontium ranelate treatment and increased incidence of venous thromboembolism (VTE), suggesting possible adverse prothrombotic effects of the drug.
  
  
  OBJECTIVE
  To assess the effect of strontium ranelate treatment on primary hemostasis, secondary hemostasis, and the natural anticoagulant defense system, together with prothrombotic markers, in elderly women with osteoporosis.
  
  
  METHODS
  This study was designed in a prospective manner. Thirty-five elderly women diagnosed with osteoporosis were included. During a 2 month treatment period, participants received strontium ranelate 2 g. Platelet Function Analyzer-100 (PFA-100) in vitro bleeding time was performed to depict primary hemostasis. Secondary hemostatic parameters including prothrombin time, international normalized ratio, activated partial thromboplastin time, anti-cardiolipine immunoglobulin (Ig) M and IgG, antiphospholipid IgM and IgG, protein C, protein S, antithrombin III, lupus anticoagulant, fibrinogen, thrombin, activated protein C resistance, and plasma levels of d-dimer were assessed. These parameters were tested before and after 2 month treatment with strontium ranelate.
  
  
  RESULTS
  Mean +/- SD age of the patients was 72.82 +/- 5.69 years. After 60 days of treatment, there was no statistically significant prolongation in PFA-100 in vitro bleeding time and no statistically significant change in the critical hemostatic parameters in patients receiving strontium ranelate that led to discontinuation of the treatment. None of the subjects developed clinical VTE during the 2 month period of strontium ranelate treatment.
  
  
  CONCLUSIONS
  The hemostatic safety of strontium ranelate in the elderly population with osteoporosis was shown over 2 months of treatment; however, its long-term hemostatic safety should be evaluated further.
authors.affiliation: Medical Faculty, Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University, Ankara, Turkey. meltemhalil@yahoo.com
authors.forename: Meltem
authors.initials: M
authors.lastname: Halil
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cankurtaran
authors.forename: Burcu Balam
authors.initials: BB
authors.lastname: Yavuz
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Ulger
authors.forename: Serhan
authors.initials: S
authors.lastname: Piskinpasa
authors.forename: Arzu
authors.initials: A
authors.lastname: Gedik
authors.forename: Ibrahim Celalettin
authors.initials: IC
authors.lastname: Haznedaroglu
authors.forename: Serafettin
authors.initials: S
authors.lastname: Kirazli
authors.forename: Servet
authors.initials: S
authors.lastname: Ariogul
mesh_terms: D000368:Aged; D001760:Bleeding Time; D005260:Female; D006490:Hemostatics / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D010024:Osteoporosis / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D006490:Hemostatics; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate