title: Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia.
abstract: Many fractures occur in women with moderate fracture risk caused by osteopenia. Strontium ranelate was studied in 1431 postmenopausal women with osteopenia. Vertebral fracture risk reduction of 41-59% was shown depending on the site and fracture status at baseline. This is the first report of antivertebral fracture efficacy in women with vertebral osteopenia.
  
  
  BACKGROUND
  Women with osteoporosis are at high risk for fracture. However, more than one half of all fractures in the community originate from the larger population at more moderate risk of fracture caused by osteopenia. Despite this, evidence for antifracture efficacy in these persons is limited. The aim of this study was to determine whether strontium ranelate, a new drug that reduces fracture risk in women with osteoporosis, is also effective in women with osteopenia.
  
  
  METHODS
  Data from the Spinal Osteoporosis Therapeutic Intervention study (SOTI; n = 1649) and the TReatment Of Peripheral OSteoporosis (TROPOS; n = 5091) were pooled to evaluate the antivertebral fracture efficacy of strontium ranelate in women with lumbar spine (LS) osteopenia with any BMD value at the femoral neck (FN; N = 1166) and in 265 women with osteopenia at both sites (intention-to-treat analysis). The women were randomized to strontium ranelate 2 g/d orally or placebo for 3 yr.
  
  
  RESULTS
  No group differences were present in baseline characteristics that may influence fracture outcome independent of therapy. In women with LS osteopenia, treatment reduced the risk of vertebral fracture by 41% (RR = 0.59; 95% CI, 0.43-0.82), by 59% (RR = 0.41; 95% CI, 0.17-0.99) in the 447 patients with no prevalent fractures, and by 38% (RR = 0.62; 95% CI, 0.44-0.88) in the 719 patients with prevalent fractures. In women with osteopenia at both sites, treatment reduced the risk of fracture by 52% (RR = 0.48; 95% CI, 0.24-0.96).
  
  
  CONCLUSIONS
  Strontium ranelate safely reduces the risk of vertebral fractures in women with osteopenia with or without a prevalent fracture.
authors.affiliation: Austin Health, University of Melbourne, Melbourne, Australia. egos@unimelb.edu.au
authors.forename: Ego
authors.initials: E
authors.lastname: Seeman
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Devogelaer
authors.forename: Roman
authors.initials: R
authors.lastname: Lorenc
authors.forename: Timothy
authors.initials: T
authors.lastname: Spector
authors.forename: Kim
authors.initials: K
authors.lastname: Brixen
authors.forename: Adam
authors.initials: A
authors.lastname: Balogh
authors.forename: Gerold
authors.initials: G
authors.lastname: Stucki
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D013131:Spine; D013876:Thiophenes / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate