Long-term strontium ranelate treatment reduces the risk of nonvertebral and vertebral fractures in women with postmenopausal osteoporosis, according to a report in the June issue of Arthritis & Rheumatism.
"There are now several first-line treatments for osteoporosis," Dr. Jean-Yves Reginster from the University of Liege, Belgium told Reuters Health. The present study "is the first one to demonstrate anti-fracture efficacy at the level of the hip, in a 5-year, pre-planned, placebo-controlled, prospective study."
Dr. Reginster and colleagues evaluated the efficacy of strontium ranelate in reducing nonvertebral (peripheral) fractures and vertebral fractures over 5 years in 4935 postmenopausal women with osteoporosis participating in the Treatment of Peripheral Osteoporosis Study.
The risk of new nonvertebral osteoporotic fractures over 5 years was 15% lower in the strontium group than in the placebo group, the authors report. This translates into a number-needed-to-treat of 44 to prevent 1 new nonvertebral fracture over 5 years.
In subset analyses, strontium significantly reduced the risk of new major nonvertebral osteoporotic fractures (by 18%) and hip fractures (by 43%), as well as the risk of vertebral fractures (by 24%), the researchers note.
Treatment was generally well tolerated, the report indicates.
"Strontium has currently shown anti-fracture efficacy in a wide scatter of patients, starting from women with osteopenia to women over the age of 80 years old," Dr. Reginster said. "In these two categories of patients, there are no studies showing efficacy for bisphosphonates."
"An 8-year open label extension is currently ongoing, a study for osteoporosis in males has just started, (and) a study investigating the use of strontium in knee osteoarthritis is ongoing," Dr. Reginster added.
Arthritis Rheum 2008;58:1687-1695.
Reviewed by Ramaz Mitaishvili, MD