Prevention of vertebral fractures by strontium ranelate in postmenopausal women with osteoporosis

The antifracture efficacy of strontium ranelate, a compound with a novel mechanism of action on bone, has been assessed in two large, randomized, controlled trials conducted in postmenopausal women. Strontium ranelate was given at a daily dose of 2 g, and all women received calcium and vitamin D supplements. In women with established osteoporosis there was a 41% reduction in vertebral fractures over 3 years’ treatment [relative risk (RR) 0.59; 95% confidence interval (CI) 0.48–0.73; P<0.001]; significant reductions were also seen after only 1 year of treatment. The beneficial effect was also seen for clinical vertebral fractures: over 3 years there was a significant reduction in new clinical vertebral fractures (RR 0.62; 95% CI 0.47–0.83; P<0.001); this reduction was also observed during the first year of treatment (RR 0.48; 95% CI 0.29–0.80; P=0.003). Over the 3-year treatment period significantly fewer patients had height loss and fewer patients reported new or worsening back pain in the treated group than in the control group. These results demonstrate that strontium ranelate is a new therapeutic option in the prevention of osteoporotic vertebral fractures in postmenopausal women.