Journal of Clinical Densitometry
Volume 10, Issue 2 , Pages 113-119 , April 2007

A Review of Strontium Ranelate and Its Effect on DXA Scans

  • Glen M. Blake

      Affiliations

    • King's College London School of Medicine, London, UK
    • Corresponding Author InformationAddress correspondence to: Glen M. Blake, PhD, Department of Nuclear Medicine, Guy's Hospital, St Thomas Street, London SE1 9RT, United Kingdom.
  • ,
  • E. Michael Lewiecki

      Affiliations

    • New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM
  • ,
  • David L. Kendler

      Affiliations

    • Osteoporosis Center of British Columbia, Vancouver, BC, Canada
  • ,
  • Ignac Fogelman

      Affiliations

    • King's College London School of Medicine, London, UK

Received 5 December 2006 ,Accepted 5 January 2007.

References 

  1. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459–468
  2. Reginster JY, Seeman E, De Vernejoul MC, et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: treatment of peripheral osteoporosis (TROPOS) study. J Clin Endocrinol Metab. 2005;90:2816–2822
  3. Meunier PJ, Slosman DO, Delmas PD, et al. Strontium ranelate: dose-dependent effects in established postmenopausal vertebral osteoporosis—a 2-year randomised placebo controlled trial. J Clin Endocrinol Metab. 2002;87:2060–2066
  4. Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomised, two-year, double-masked, dose ranging, placebo-controlled PREVOS trial. Osteoporos Int. 2002;13:925–931
  5. Arlot ME, Delmas P, Burt-Pichat B, Roux JP, Portero N, Meunier PJ. The effects of strontium ranelate on bone remodelling and bone safety assessed by histomorphometry in patients with postmenopausal osteoporosis. J Bone Miner Res. 2005;20(Suppl 1):S22–S23
  6. Boivin G, Farley D, Simi C, Meunier PJ. Bone strontium distribution and degree of mineralization of bone in postmenopausal osteoporotic women treated with strontium ranelate for 2 and 3 years. Osteoporos Int. 2006;17(Suppl 2):S210
  7. Krogsgaard K, Weis M, Christgau S. A new strontium salt available in tablet form with improved bioavailability of strontium compared to strontium ranelate. Osteoporos Int. 2006;17(Suppl 2):S221
  8. Pors Nielsen S, Slosman D, Sorensen OH, et al. Influence of strontium on bone mineral density and bone mineral content measurements by dual X-ray absorptiometry. J Clin Densitom. 1999;2:371–379
  9. Blake GM, Fogelman I. The effect of bone strontium on BMD measurements. J Clin Densitom. 2007;10:34–38
  10. Ho CP, Kim RW, Schaffler MB, Sartoris DJ. Accuracy of dual-energy radiographic absorptiometry of the lumbar spine: a cadaver study. Radiology. 1990;176:171–173
  11. Shorr E, Carter AC. The usefulness of strontium as an adjuvant to calcium in the remineralization of the skeleton in man. Bull Hosp Joint Dis. 1952;13:59–66
  12. Pors Nielsen S. The biological role of strontium. Bone. 2004;35:583–588
  13. Reginster JY, Deroisy R, Juspin I. Strontium ranelate: a new paradigm in the treatment of osteoporosis. Drugs Today. 2003;39:89–101
  14. SPC . Summary of product characteristics. Protelos (Strontium ranelate 2g granules). Neuilly-sur-Seine, France: Les Laboratories Servier; 2004;
  15. Apostoaei AI. Absorption of strontium from the gastrointestinal tract into plasma in healthy human adults. Health Phys. 2002;83:56–65
  16. Genant HK, Wu CY, van Kuijk C, et al. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993;8:1137–1148
  17. Reginster JY, Meunier PJ, Roux C, et al. Strontium ranelate: an anti-osteoporotic treatment demonstrated vertebral and nonvertebral antifracture efficacy over 5 years in postmenopausal osteoporotic women. Osteoporos Int. 2006;17(Suppl 2):S138
  18. Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1991;
  19. Seeman E, Vellas B, Benhamou C, et al. Strontium ranelate reduces the risk of vertebral and nonvertebral fractures in women eighty years of age and older. J Bone Miner Res. 2006;21:1113–1120
  20. Roux C, Reginster J-Y, Fechtenbaum J, et al. Vertebral fracture risk reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors. J Bone Miner Res. 2006;21:536–542
  21. Looker AC, Wahner HW, Dunn WL, et al. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8:468–489
  22. Jonsson B, Kanis J, Dawson A, Oden A, Johnell O. Effect and offset of effect of treatments for hip fracture on health outcomes. Osteoporos Int. 1999;10:193–199
  23. Eastell R, Barton I, Hannon RA, et al. Relationship of early changes in bone resorption to the reduction in fracture risk with risedronate. J Bone Miner Res. 2003;18:1051–1056
  24. Black DM, Cummings SR, Karpf DB, et al. Randomised trial of the effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet. 1996;348:1535–1541
  25. Harris ST, Watts NB, Genant HK, et al. Effects of risedronate treatment on vertebral and non-vertebral fractures in women with postmenopausal osteoporosis. JAMA. 1999;282:1344–1352
  26. Chesnut CH, Skag A, Christiansen C, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004;19:1241–1249
  27. Ettinger B, Black DM, Mitlak BH, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomised clinical trial. JAMA. 1999;282:637–645
  28. Neer RM, Arnaud CD, Zanchetta JR, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344:1434–1441
  29. Garnero P, Shih WCJ, Gineyts E, et al. Comparison of new biochemical markers of bone turnover in late postmenopausal osteoporotic women in response to alendronate treatment. J Clin Endocrinol Metab. 1994;79:1693–1700
  30. Marie PJ, Hott M, Modrowski D, et al. An uncoupling agent containing strontium prevents bone loss by depressing bone resorption and maintaining bone formation in estrogen-deficient rats. J Bone Miner Res. 1993;8:607–615
  31. Canalis E, Hott M, Deloffre P, Tsouderos Y, Marie PJ. The divalent strontium salt S12911 enhances bone cell replication and bone formation in vitro. Bone. 1996;18:517–523
  32. Marie PJ. Strontium ranelate: a novel mode of action optimizing bone formation and bone resorption. Osteoporos Int. 2005;16(Suppl 1):S7–S10
  33. Ammann P, Shen V, Robin B, Mauras Y, Bonjour J-P, Rizzoli R. Strontium ranelate improves bone resistance by increasing bone mass and improving architecture in intact female rats. J Bone Miner Res. 2004;19:2012–2020
  34. Ammann P. Strontium ranelate: a novel mode of action leading to renewed bone quality. Osteoporos Int. 2005;16(Suppl 1):S11–S15
  35. Ammann P, Badoud I, Barrauld S, Chatelain P, Rizzoli R. Strontium ranelate improves intrinsic bone tissue quality. J Bone Miner Res. 2005;20(Suppl 1):S347
  36. Jiang Y, Genant H, Zhao J. Effect of strontium ranelate on 3D cortical and trabecular microstructure in postmenopausal osteoporosis in multicentre, double-blind, and placebo controlled studies. J Bone Miner Res. 2006;21(Suppl 1):S44
  37. Ortolani S, Diaz-Curiel M. Strontium ranelate: changes in BMD one year after treatment discontinuation. J Bone Miner Res. 2006;21(Suppl 1):S189
  38. Liberman UA, Weiss SR, Broll J, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med. 1995;333:1437–1443
  39. Lindsay R, Nieves J, Formica C, et al. Randomised controlled study of effect of parathyroid hormone on vertebral-bone mass and fracture incidence among postmenopausal women on oestrogen with osteoporosis. Lancet. 1997;350:550–555
  40. Fogelman I, Blake GM. Strontium ranelate for the treatment of osteoporosis. BMJ. 2005;330:1400–1401
  41. Blake GM, Fogelman I. Long-term effect of strontium ranelate treatment on BMD. J Bone Miner Res. 2005;20:1901–1904
  42. Marshall JH, Lloyd EL, Rundo J, et al. Alkaline earth metabolism in adult man. A report prepared by a task group of Committee 2 of the International Commission on Radiological Protection. [ICRP Publication 20] Health Phys. 1973;24:129–221
  43. Blake GM, Fogelman I. Theoretical model for the interpretation of BMD scans in patients stopping strontium ranelate treatment. J Bone Miner Res. 2006;21:1417–1424
  44. Dahl SG, Allain P, Marie PJ, et al. Incorporation and distribution of strontium in bone. Bone. 2001;28:446–453
  45. Goldman M, Della Rosa RJ. Studies of the dynamics of strontium metabolism under conditions of continual ingestion to maturity. In:  Lenihan JMA,  Loutit JF,  Martin JH editor. Strontium Metabolism. New York: Academic Press; 1967;p. 181–194
  46. Bruyere O, Roux C, Cannata JB, et al. Associations between increase in bone mineral density and decrease in clinical vertebral fracture incidence during a treatment with strontium ranelate. Osteoporos Int. 2006;17(Suppl 1):S8
  47. Kanis JA, Borgstrom F, De Laet C, et al. Assessment of fracture risk. Osteoporos Int. 2005;16:581–589

PII: S1094-6950(07)00005-4

doi: 10.1016/j.jocd.2007.01.002

Journal of Clinical Densitometry
Volume 10, Issue 2 , Pages 113-119 , April 2007