title: Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate.
abstract: OBJECTIVE
  Our objective was to analyze the relationship between bone mineral density (BMD) changes and fracture incidence during 3-yr treatment with strontium ranelate.
  
  
  METHODS
  Women from the strontium ranelate arm of the Spinal Osteoporosis Therapeutic Intervention study and the TReatment Of Peripheral OSteoporosis study were evaluated.
  
  
  METHODS
  The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based on written documentation.
  
  
  RESULTS
  After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1-5%) and 2% (1-4%) reduction in risk of a new vertebral fracture, respectively. The 3-yr changes in femoral neck and total proximal femur BMD explained 76% and 74%, respectively, of the reduction in vertebral fractures observed during the treatment. Three-year changes in spine BMD were not statistically associated with the incidence of new vertebral fracture (P = 0.10). No significant associations were found between 3-yr changes in BMD and incidence of new nonvertebral fractures, but a trend was found for femoral neck BMD (P = 0.09) and for total proximal femur BMD (P = 0.07). An increase in femoral neck BMD after 1 yr was significantly associated with the reduction in incidence of new vertebral fractures observed after 3 yr (P = 0.04).
  
  
  CONCLUSIONS
  During 3-yr strontium ranelate treatment, an increase in femoral neck BMD was associated with a proportional reduction in vertebral fracture incidence.
authors.affiliation: World Health Organization Collaborating Center for Public Health Aspect of Osteoarticular Disorders, University of Liège, B-4000 Liège, Belgium. olivier.bruyere@ulg.ac.be
authors.forename: Olivier
authors.initials: O
authors.lastname: Bruyere
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
authors.forename: Johann
authors.initials: J
authors.lastname: Detilleux
authors.forename: Daniel O
authors.initials: DO
authors.lastname: Slosman
authors.forename: Tim D
authors.initials: TD
authors.lastname: Spector
authors.forename: Patrice
authors.initials: P
authors.lastname: Fardellone
authors.forename: Kim
authors.initials: K
authors.lastname: Brixen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Devogelaer
authors.forename: Manuel
authors.initials: M
authors.lastname: Diaz-Curiel
authors.forename: Carlina
authors.initials: C
authors.lastname: Albanese
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Kaufman
authors.forename: Stig
authors.initials: S
authors.lastname: Pors-Nielsen
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005269:Femur / Q000187:drug effects; D005272:Femur Neck / Q000187:drug effects; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D010024:Osteoporosis / Q000188:drug therapy; D040242:Risk Reduction Behavior; D016103:Spinal Fractures / Q000453:epidemiology; D013131:Spine / Q000187:drug effects; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate; D014807:Vitamin D; D002118:Calcium