title: Efficacy and safety of strontium ranelate in the treatment of osteoporosis in men.
abstract: BACKGROUND
  Strontium ranelate reduces vertebral and nonvertebral fracture risk in postmenopausal osteoporosis.
  
  
  OBJECTIVE
  The objective of this study was to determine the efficacy and safety of strontium ranelate in osteoporosis in men over 2 years (main analysis after 1 year).
  
  
  METHODS
  This was an international, unbalanced (2:1), double-blind, randomized placebo-controlled trial (MALEO [MALE Osteoporosis]).
  
  
  METHODS
  This international study included 54 centers in 14 countries.
  
  
  METHODS
  PARTICIPANTS were 261 white men with primary osteoporosis.
  
  
  METHODS
  Strontium ranelate at 2 g/d (n = 174) or placebo (n = 87) was administered.
  
  
  METHODS
  Lumbar spine (L2-L4), femoral neck, and total hip bone mineral density (BMD), biochemical bone markers, and safety were measured.
  
  
  RESULTS
  Baseline characteristics were similar in both groups in the whole population (age, 72.9 ± 6.0 years; lumbar spine BMD T-score, -2.7 ± 1.0; femoral neck BMD T-score, -2.3 ± 0.7). Men who received strontium ranelate over 2 years had greater increases in lumbar spine BMD than those who received placebo (relative change from baseline to end, 9.7% ± 7.5% vs 2.0% ± 5.5%; between-group difference estimate (SE), 7.7% (0.9%); 95% confidence interval, 5.9%-9.5%; P < .001). There were also significant between-group differences in relative changes in femoral neck BMD (P < .001) and total hip BMD (P < .001). At the end of treatment, mean levels of serum cross-linked telopeptides of type I collagen, a marker of bone resorption, were increased in both the strontium ranelate group (10.7% ± 58.0%; P = .022) and the placebo group (34.9% ± 65.8%; P < .001). The corresponding mean changes of bone alkaline phosphatase, a marker of bone formation, were 6.4% ± 28.5% (P = .005) and 1.9% ± 25.4% (P = .505), respectively. After 2 years, the blood strontium level (129 ± 66 μmol/L) was similar to that in trials of postmenopausal osteoporosis. Strontium ranelate was generally well tolerated.
  
  
  CONCLUSIONS
  The effects of strontium ranelate on BMD in osteoporotic men were similar to those in postmenopausal osteoporotic women, supporting its use in the treatment of osteoporosis in men.
authors: Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. jean.kaufman@ugent.be
authors: J-M
authors: JM
authors: Kaufman
authors: M
authors: M
authors: Audran
authors: G
authors: G
authors: Bianchi
authors: V
authors: V
authors: Braga
authors: M
authors: M
authors: Diaz-Curiel
authors: R M
authors: RM
authors: Francis
authors: S
authors: S
authors: Goemaere
authors: R
authors: R
authors: Josse
authors: S
authors: S
authors: Palacios
authors: J D
authors: JD
authors: Ringe
authors: D
authors: D
authors: Felsenberg
authors: S
authors: S
authors: Boonen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D010024:Osteoporosis / Q000188:drug therapy*; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate