title: Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial.
abstract: BACKGROUND
  Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis.
  
  
  METHODS
  Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) 2.5-5 mm) were randomly allocated to strontium ranelate 1 g/day (n=558), 2 g/day (n=566) or placebo (n=559). The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment) over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee pain. The trial is registered (ISRCTN41323372).
  
  
  RESULTS
  The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56) mm; 2 g/day: -0.27 (SD 0.63) mm; placebo: -0.37 (SD 0.59) mm); treatment-placebo differences were 0.14 (SE 0.04), 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04), 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed with strontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day). There were greater reductions in total WOMAC score (p=0.045), pain subscore (p=0.028), physical function subscore (p=0.099) and knee pain (p=0.065) with strontium ranelate 2 g/day. Strontium ranelate was well tolerated.
  
  
  CONCLUSIONS
  Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day.
authors.affiliation: Correspondence to Professor Jean-Yves Reginster, Department of Public Health and Health Economics, University of Liege, 4020 Liege, Belgium. jyreginster@ulg.ac.be
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Reginster
authors.forename: Janusz
authors.initials: J
authors.lastname: Badurski
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bellamy
authors.forename: William
authors.initials: W
authors.lastname: Bensen
authors.forename: Roland
authors.initials: R
authors.lastname: Chapurlat
authors.forename: Xavier
authors.initials: X
authors.lastname: Chevalier
authors.forename: Claus
authors.initials: C
authors.lastname: Christiansen
authors.forename: Harry
authors.initials: H
authors.lastname: Genant
authors.forename: Federico
authors.initials: F
authors.lastname: Navarro
authors.forename: Evgeny
authors.initials: E
authors.lastname: Nasonov
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Spector
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D013876:Thiophenes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate