Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia.
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.
Seeman
Ego
E
Austin Health, University of Melbourne, Melbourne, Australia. egos@unimelb.edu.au
Devogelaer
Jean-Pierre
JP
Lorenc
Roman
R
Spector
Timothy
T
Brixen
Kim
K
Balogh
Adam
A
Stucki
Gerold
G
Reginster
Jean-Yves
JY
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
D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate