Long-term effect of strontium ranelate on serum C-terminal propeptide of type I Procollagen (PICP) and urine cross-linked N-telopeptide (U-NTX) in women with postmenopausal osteoporosis

in Annals of the Rheumatic Diseases (2010, June), 69(Suppl.3), 602

Strontium ranelate: long-term efficacy against vertebral, nonvertebral and hip fractures in patients with postmenopausal osteoporosis

in Therapeutic Advances in Musculoskeletal Disease (2010), 2(3), 133-143

Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile, optimizing therapeutic adherence ... [more ▼]

Osteoporosis treatments need to combine an unequivocally demonstrated reduction of fractures, at various skeletal sites, long-term safety, and a user-friendly profile, optimizing therapeutic adherence. Strontium ranelate is the first compound to simultaneously decrease bone resorption and stimulate bone formation. Its antifracture efficacy, at various skeletal sites, has been established up to 8 years, through studies of the highest methodological standards. Increases in bone mineral density, observed after 1 year of treatment, are predictive of the long-term fracture efficacy, hence suggesting, for the first time in osteoporosis, that bone densitometry can be used as a monitoring tool for both efficacy and compliance. Owing to a positive benefit/risk ratio, strontium ranelate may now be considered as a first-line treatment in the management of osteoporosis [less ▲]

The impact of nutrition on bone health

in Osteoporosis International (2010, May), 21(Suppl.1), 389

Effects of arzoxifene on fracture incidence in postmenopausal women with osteoporosis or with low bone mass

in Osteoporosis International (2010, May), 21(Suppl.1), 23-24

A FRAX® model for the assessment of fracture probability in Belgium

in Osteoporosis International (2010, May), 21(Suppl.1), 255

Cost-effectiveness of glucosamine sulfate compared to acetaminophen in the treatment of knee osteoarthrits: a French health care perspective

in Osteoporosis International (2010, May), 21(Suppl.1), 167

Cost-effectiveness of denosumab compared with oral bisphosphonates in the treatment of postmenopausal osteoporotic women

in Osteoporosis International (2010, May), 21(S1), 30

Oral calcitonin in the management of osteoarthritis: hope or fantasy ?

in International Journal of Clinical Rheumatology (2010), 5(1), 53-58

In the mid-1980s, calcitonin was used as a potential treatment for postmenopausal osteoporosis. However, after the results obtained in a pivotal study assessing the antifracture efficacy of the drug ... [more ▼]

In the mid-1980s, calcitonin was used as a potential treatment for postmenopausal osteoporosis. However, after the results obtained in a pivotal study assessing the antifracture efficacy of the drug showed an absence of reduction in nonvertebral fractures, calcitonin has almost completely disappeared from the osteoporosis armomentarium. The development of a new ‘high-tech’ oral formulation of salmon calcitonin and the demonstration, in several in vitro and in vivo models of osteoarthritis, that this drug could exert beneficial effects on the chondrocytes and on the development of experimental osteoarthritis has generated some interest in this old molecule. However, at this stage, results from clinical trials remain inconclusive and caution should be exerted before considering oral calcitonin as a breakthrough in the management of osteoarthritis. [less ▲]

Vertebral anti-fracture efficacy of strontium ranelate according to pre-treatment bone turnover.

in Osteoporosis International (2010), 21(2), 233-41

Osteoporotic post-menopausal women patients in two randomised trials comparing the anti-fracture efficacy of strontium ranelate with placebo were separated into tertiles according to their baseline levels ... [more ▼]

Osteoporotic post-menopausal women patients in two randomised trials comparing the anti-fracture efficacy of strontium ranelate with placebo were separated into tertiles according to their baseline levels of biochemical markers of bone formation and resorption. The vertebral anti-fracture efficacy of strontium ranelate was shown to be independent of baseline bone turnover levels. INTRODUCTION: Bone turnover (BTO) levels vary among women at risk of osteoporotic fracture. Strontium ranelate is an anti-osteoporotic treatment increasing bone formation and reducing bone resorption. It was hypothesised that its anti-fracture efficacy would be independent of baseline BTO levels. METHODS: Post-menopausal women with osteoporosis from two pooled studies were stratified in tertiles according to baseline levels of two BTO markers: bone-specific alkaline phosphatase (b-ALP, n = 4995) and serum C-telopeptide cross-links (sCTX, n = 4891). Vertebral fracture risk was assessed over 3 years with strontium ranelate 2 g/day or placebo. RESULTS: In the placebo group, relative risk of vertebral fractures increased with BTO tertiles by 32% and 24% for patients in the highest tertile for b-ALP and CTX, respectively, compared to those in the lowest tertile. In the strontium ranelate group, incidences of vertebral fracture did not differ significantly across BTO tertiles. Significant reductions in vertebral fractures with strontium ranelate were seen in all tertiles of both markers, with relative risk reductions of 31% to 47% relative to placebo. Risk reduction did not differ among tertiles (b-ALP: p = 0.513; sCTX: p = 0.290). CONCLUSION: The vertebral anti-fracture efficacy of strontium ranelate was independent of baseline BTO levels. Strontium ranelate offers clinical benefits to women across a wide range of metabolic states. [less ▲]

Loading and skeletal development and maintenance.

in Journal of Osteoporosis (2010), 2011

Mechanical loading is a major regulator of bone mass and geometry. The osteocytes network is considered the main sensor of loads, through the shear stress generated by strain induced fluid flow in the ... [more ▼]

Mechanical loading is a major regulator of bone mass and geometry. The osteocytes network is considered the main sensor of loads, through the shear stress generated by strain induced fluid flow in the lacuno-canalicular system. Intracellular transduction implies several kinases and phosphorylation of the estrogen receptor. Several extra-cellular mediators, among which NO and prostaglandins are transducing the signal to the effector cells. Disuse results in osteocytes apoptosis and rapid imbalanced bone resorption, leading to severe osteoporosis. Exercising during growth increases peak bone mass, and could be beneficial with regards to osteoporosis later in life, but the gain could be lost if training is abandoned. Exercise programs in adults and seniors have barely significant effects on bone mass and geometry at least at short term. There are few data on a possible additive effect of exercise and drugs in osteoporosis treatment, but disuse could decrease drugs action. Exercise programs proposed for bone health are tedious and compliance is usually low. The most practical advice for patients is to walk a minimum of 30 to 60 minutes per day. Other exercises like swimming or cycling have less effect on bone, but could reduce fracture risk indirectly by maintaining muscle mass and force. [less ▲]