Article (Scientific journals)
Cardiac concerns associated with strontium ranelate.
Reginster, Jean-Yves
2014In Expert Opinion on Drug Safety, 13 (9), p. 1-5
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Keywords :
cardiac safety; myocardial infarction; osteoporosis; strontium ranelate
Abstract :
[en] Introduction: Strontium ranelate is proven to reduce vertebral and non-vertebral fracture risk in osteoporosis. Concerns about cardiac safety have led to a new contraindication to strontium ranelate in patients with uncontrolled hypertension and/or current or past history of ischaemic heart disease, peripheral arterial disease and/or cerebrovascular disease. Areas covered: A literature search was performed; data were also collected from the European Medicines Agency website. Randomised controlled trial (RCT) data indicate a higher incidence of non-adjudicated myocardial infarction (MI) with strontium ranelate versus placebo (1.7 vs 1.1%; odds ratio [OR]: 1.6; 95% CI: 1.07 - 2.38; p = 0.020) (Mantel-Haenzel estimate of the OR). There was no increase in cardiovascular mortality. MI risk was mitigated by excluding patients with cardiovascular contraindications (OR: 0.99; 95% CI: 0.48 - 2.04; p = 0.988). Three observational studies performed in the context of real-life medical practice in the UK and Denmark did not report a signal. Expert opinion: The increased risk for cardiac events with strontium ranelate has been detected in RCTs but not in real life. Excluding patients with cardiovascular contraindications appears to be an effective measure for controlling the risk of MI. Strontium ranelate remains a useful therapeutic alternative in patients with severe osteoporosis without cardiovascular contraindications who are unable to take another osteoporosis treatment.
Disciplines :
General & internal medicine
Author, co-author :
Reginster, Jean-Yves  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Cardiac concerns associated with strontium ranelate.
Publication date :
2014
Journal title :
Expert Opinion on Drug Safety
ISSN :
1474-0338
eISSN :
1744-764X
Publisher :
Taylor & Francis, United Kingdom
Volume :
13
Issue :
9
Pages :
1-5
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 17 July 2014

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