[en] Many fractures occur in women with moderate fracture risk caused by osteopenia. Strontium ranelate was studied in 1431 postmenopausal women with osteopenia. Vertebral fracture risk reduction of 41-59% was shown depending on the site and fracture status at baseline. This is the first report of antivertebral fracture efficacy in women with vertebral osteopenia. INTRODUCTION: Women with osteoporosis are at high risk for fracture. However, more than one half of all fractures in the community originate from the larger population at more moderate risk of fracture caused by osteopenia. Despite this, evidence for antifracture efficacy in these persons is limited. The aim of this study was to determine whether strontium ranelate, a new drug that reduces fracture risk in women with osteoporosis, is also effective in women with osteopenia. MATERIALS AND METHODS: Data from the Spinal Osteoporosis Therapeutic Intervention study (SOTI; n = 1649) and the TReatment Of Peripheral OSteoporosis (TROPOS; n = 5091) were pooled to evaluate the antivertebral fracture efficacy of strontium ranelate in women with lumbar spine (LS) osteopenia with any BMD value at the femoral neck (FN; N = 1166) and in 265 women with osteopenia at both sites (intention-to-treat analysis). The women were randomized to strontium ranelate 2 g/d orally or placebo for 3 yr. RESULTS: No group differences were present in baseline characteristics that may influence fracture outcome independent of therapy. In women with LS osteopenia, treatment reduced the risk of vertebral fracture by 41% (RR = 0.59; 95% CI, 0.43-0.82), by 59% (RR = 0.41; 95% CI, 0.17-0.99) in the 447 patients with no prevalent fractures, and by 38% (RR = 0.62; 95% CI, 0.44-0.88) in the 719 patients with prevalent fractures. In women with osteopenia at both sites, treatment reduced the risk of fracture by 52% (RR = 0.48; 95% CI, 0.24-0.96). CONCLUSIONS: Strontium ranelate safely reduces the risk of vertebral fractures in women with osteopenia with or without a prevalent fracture.
Disciplines :
General & internal medicine
Author, co-author :
Seeman, Ego
Devogelaer, Jean*-Pierre
Lorenc, Roman
Spector, Timothy
Brixen, Kim
Balogh, Adam
Stucki, Gerold
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie et santé publique
Language :
English
Title :
Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia.
Publication date :
2008
Journal title :
Journal of Bone and Mineral Research
ISSN :
0884-0431
eISSN :
1523-4681
Publisher :
American Society for Bone and Mineral Research, Washington, United States - District of Columbia
Consensus Development Conference 1993 Diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 94:646-650.
World Health Organization. Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. World Health Organization, Geneva, Switzerland, pp. 1-129.
Jordan KM, Cooper C 2002 Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 16:795-806.
Siris ES, Chen YT, Abbott TA, Barrett-Connor E, Miller PD, Wehren LE, Berger ML 2004 Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med 164:1108-1112.
Sanders KM, Nicholson GC, Watts JJ, Pasco JA, Henry MJ, Kotowicz MA, Seeman E 2006 Half the burden of fragility fractures in the community occur in women without osteoporosis. When is fracture prevention cost effective? Bone 38:694-700.
Delmas PDD 2002 Treatment of postmenopausal osteoporosis. Lancet 359:2018-2026.
Simon JA 2005 Does osteopenia warrant treatment? Menopause 12:639-648.
Meunier PJ, Roux C, Seeman E, Ortolani S, Badurski JE, Spector TD, Cannata J, Balogh A, Lemmel EM, Pors-Nielsen S, Rizzoli R, Genant HK, Reginster JY 2004 The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459-468.
Reginster JY, Seeman E, De Vernejoul MC, Adami S, Compston J, Phenekos C, Devogelaer JP, Curiel MD, Sawicki A, Goemaere S, Sorensen OH, Felsenberg D, Meunier PJ 2005 Strontium ranelate reduces the risk of non vertebral fractures in postmenopausal women with osteoporosis: TReatment Of Peripheral OSsteoporosis (TROPOS) Study. J Clin Endocrinol Metab 90:2816-2822.
Genant HK, Wu CY, Van Kuijk C, Nevitt MC 1993 Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:1137-1148.
Slosman D, Provvedini DM, Meunier PJ, Delmas PD, Sebert JL, De Vernejoul MC, Tsouderos Y, Reginster JY 1999 The use of different dual X-ray absorptiometry brands in a multicenter clinical trial. J Clin Densitom 2:37-44.
Kanis JA, Johnell O, Black DM, Downs RW, Sarkar S, Fuerst T, Secrest RJ, Pavo I 2003 Effect of raloxifene on the risk of new vertebral fracture in postmenopausal women with osteopenia or osteoporosis: A reanalysis of the Multiple Outcomes of Raloxifene Evaluation Trial. Bone 33:293-300.
Quandt SA, Thomspon DE, Schneider DL, Nevitt MC, Black DM 2005 Fracture intervention Trial Research Group. Effect of alendronate on vertebral fracture risk in women with bone mineral density T scores of -1.6 to -2.5 at the femoral neck: The Fracture Intervention Trial. Mayo Clin Proc 80:343-349.
Heaney RP, Zizic TM, Fogelman I, Oszynski WP, Geusens P, Kasibhatla C, Alsayed N, Isaia G, Davie MW, Chesnut CH 2002 Risedronate reduces the risk of first vertebral fracture in osteoporotic women. Osteoporos Int 13:501-505.
Sornay-Rendu E, Munoz F, Garnero P, Duboeuf F, Delmas PD 2005 Identification of osteopenic women at high risk of fracture: The OFELY Study. J Bone Miner Res 20:1813-1819.
Garnero P, Delmas PD 2004 Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. J Musculoskel Neuron Interact 4:50-63.
