Strontium ranelate is a new agent developed for the management of
post-menopausal osteoporosis. It has a unique mode of action, based on an uncoupling between bone formation (increased) and
bone resorption (decreased). To review its effectiveness we searched the MEDLINE database from 1985 to 2008, as well as databases such as the Cochrane controlled register, for citations or relevant articles. After this extensive search of the literature, a critical appraisal of the data was obtained through a consensus meeting (AN, MH, SS, OB, and J-YR). We found that
strontium ranelate reduces vertebral, nonvertebral, major nonvertebral, and
hip fractures over 1, 3, 4, and 5 years. Its spectrum of activity covers women with
osteopenia,
osteoporosis, and severe
osteoporosis. Elderly subjects also show a reduction in vertebral and nonvertebral fractures. Bone mineral density may be used as a monitoring tool for
strontium ranelate, since early changes are predictive of long-term
fracture reduction.
Biochemical markers of bone turnover reflect the uncoupling between resorption and formation. The safety profile of
strontium ranelate compares favorably with the other currently marketed antiosteoporosis medications. Preliminary results suggest that
strontium ranelate is able to reduce the progression of
spine osteoarthritis. In conclusion,
strontium ranelate has the potential to be a candidate for first-line treatment of
osteopenia and
osteoporosis. However, further research is needed before suggesting its widespread use in
osteoarthritis.