Skip to main content

Advertisement

SpringerLink
Log in

Addressing the age-related needs of osteoporotic patients with strontium ranelate

  • Review
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Osteoporotic fractures are associated with significant morbidity and mortality with an enormous impact on society and the lives of affected individuals. Age and menopause are the two main risk factors for osteoporosis, and women therefore need to be particularly concerned about bone loss at this time. In addition to suffering fracture-associated morbidity, women with prior fractures have an increased risk of future fractures. Young postmenopausal women who have experienced a fragility fracture therefore face a lifetime of fracture risk. The burden of fractures increases with advancing age, and bone mineral density declines, with women over the age of 80 years having the highest risk of fracture because of their high prevalence of osteoporosis and an increased likelihood of falls. A number of antiosteoporotic agents are available for the treatment of postmenopausal women including bisphosphonates, raloxifene, teriparatide, and strontium ranelate. For osteoporotic drugs to be beneficial in reducing the burden of fractures, they need to be effective against fracture in all age groups of postmenopausal women. With its dual mode of action, strontium ranelate is the first agent with proven early and sustained antifracture efficacy in all age groups including young postmenopausal women and those over 80 years. Evidence is now available to show that all women, including the elderly, can benefit from treatment to prevent further bone loss and restore lost bone to decrease the risk of further fractures. By implementing procedures to identify those at greatest risk and initiate safe and effective treatments, physicians can significantly improve patients' quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. National Institute for Health and Clinical Excellence (2009) Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women. NICE technology appraisal guidance 160. Available via: http//:www.nice.org.uk/TA160. Accessed December 2009

  2. Melton LJ 3rd, Thamer M, Ray NF, Chan JK, Chesnut CH 3rd, Einhorn TA, Johnston CC, Raisz LG, Silverman SL, Siris ES (1997) Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation. J Bone Miner Res 12:16–23

    Article  PubMed  Google Scholar 

  3. Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(Suppl 5):505S–511S

    Article  CAS  PubMed  Google Scholar 

  4. Gullberg B, Johnell O, Kanis JA (1997) Worldwide projections for hip fracture. Osteoporos Int 7:407–413

    Article  CAS  PubMed  Google Scholar 

  5. Dennison E, Mohamed MA, Cooper C (2006) Epidemiology of osteoporosis. Rheum Dis Clin North Am 32:617–629

    Article  PubMed  Google Scholar 

  6. Johnell O, Kanis JA (2004) An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 15:897–902

    Article  CAS  PubMed  Google Scholar 

  7. Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238

    Article  CAS  PubMed  Google Scholar 

  8. van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522

    Article  PubMed  Google Scholar 

  9. Looker AC, Orwoll ES, Johnston CC Jr et al (1997) Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 12:1761–1768

    Article  CAS  PubMed  Google Scholar 

  10. Kanis JA, Adami S (1994) Bone loss in the elderly. Osteoporos Int 4(Suppl 1):59–65

    Article  PubMed  Google Scholar 

  11. Seeman E, Vellas B, Benhamou CL et al (2006) Strontium ranelate reduces the risk of vertebral and nonvertebral fractures in women aged eighty years and over. J Bone Miner Res 21:1113–1120

    Article  CAS  PubMed  Google Scholar 

  12. Cummings SR, Melton JR III (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767

    Article  PubMed  Google Scholar 

  13. Grados F, Marcellib C, Dargent-Molinac P, Roux C, Vergnola JF, Meuniere PJ, Fardellonea P (2004) Prevalence of vertebral fractures in French women older than 75 years from the EPIDOS study. Bone 34:362–367

    Article  CAS  PubMed  Google Scholar 

  14. Cooper C, Campion G, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    Article  CAS  PubMed  Google Scholar 

  15. Rizzoli R, Bruyere O, Cannata-Andia JB, Devogelaer JP, Lyritis G, Ringe JD, Vellas B, Reginster JY (2009) Management of osteoporosis in the elderly. Curr Med Res Opin 25:2373–2387

    Article  CAS  PubMed  Google Scholar 

  16. Rolland Y, Abellan van Kan G, Bénétos A, Blain H, Bonnefoy M, Chassagne P et al (2008) Frailty, osteoporosis and hip fracture: causes, consequences and therapeutic perspectives. J Nutr Health Aging 12:335–346

    Article  CAS  PubMed  Google Scholar 

  17. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, for the Study of Osteoporotic Fractures Research Group et al (2007) Frailty and risk of falls, fracture and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 62:744–751

    PubMed  Google Scholar 

  18. Nevitt MC, Ettinger B, Black DM et al (1998) The association of radiographically detected vertebral fracture with back pain and function: a prospective study. Ann Intern Med 128:793–800

    CAS  PubMed  Google Scholar 

  19. Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 332:767–773

    Article  CAS  PubMed  Google Scholar 

  20. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382

    Article  CAS  PubMed  Google Scholar 

  21. Center JR, Bliuc D, Nguyen TV, Eisman JA (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394

    Article  CAS  PubMed  Google Scholar 

  22. Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D (2000) Risk of mortality following clinical fractures. Osteoporos Int 11:556–561

    Article  CAS  PubMed  Google Scholar 

  23. Leibson CL, Tosteson AN, Gabriel SE, Ransom JE, Melton LJ (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 50:1644–1650

    Article  PubMed  Google Scholar 

  24. Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C (2009) Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int 20:1633–1650

    Article  CAS  PubMed  Google Scholar 

  25. Richmond J, Aharonoff GB, Zuckerman JD, Koval KJ (2003) Mortality risk after hip fracture. J Orthop Trauma 17:53–56

    Article  PubMed  Google Scholar 

  26. Boonen S, Singer AJ (2008) Osteoporosis management: impact of fracture type on cost and quality of life in patients at risk for fracture. Curr Med Res Opin 24:1781–1788

    Article  PubMed  Google Scholar 

  27. Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, Quine S (2000) Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ 320:341–346

    Article  CAS  PubMed  Google Scholar 

  28. von Friesendorff M, Besjakov J, Akesson K (2008) Long-term survival and fracture risk after hip fracture: a 22-year follow-up in women. J Bone Miner Res 23:1832–1841

    Article  Google Scholar 

  29. Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D (1997) Guidelines for diagnosis and management of osteoporosis. The European foundation for osteoporosis and bone disease. Osteoporos Int 7:390–406

    Article  CAS  PubMed  Google Scholar 

  30. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475

    Article  PubMed  Google Scholar 

  31. Hamdy NAT (2007) Novel approaches to living bone. In: Roux C (ed) The living skeleton. Kluwer, France, pp 27–40

    Google Scholar 

  32. Seeman E (2007) The size, shape, spatial distribution and strength of bone in adulthood. In: Roux C (ed) The living skeleton. Kluwer, France, pp 27–40

    Google Scholar 

  33. Hunter DJ, Sambrook PN (2000) Bone loss: epidemiology of bone loss. Arthritis Res 2:441–445

    Article  CAS  PubMed  Google Scholar 

  34. Felsenberg D, Boonen S (2005) The bone quality framework: determinants of bone strength and their interrelationships, and implications for osteoporosis management. Clin Ther 27:1–11

    Article  PubMed  Google Scholar 

  35. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397

    Article  CAS  PubMed  Google Scholar 

  36. European Medicines Agency (2010) Committee for Medicinal Products for Human Use summary of positive opinion for Prolia. London, 17 December 2009. Available at: http://www.ema.europa.eu/pdfs/human/opinion/Prolia_77616809en.pdf. Accessed March 2010

  37. Marie PJ (2006) Strontium ranelate: a dual mode of action rebalancing bone turnover in favour of bone formation. Curr Opin Rheumatol 18(Suppl 1):S11–S15

    Article  PubMed  Google Scholar 

  38. Meunier PJ, Reginster JY (2003) Design and methodology of the phase 3 trials for the clinical development of strontium ranelate in the treatment of women with postmenopausal osteoporosis. Osteoporosis Int 14(Suppl 3):S66–S76

    CAS  Google Scholar 

  39. Meunier PJ, Roux C, Seeman E et al (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459–468

    Article  CAS  PubMed  Google Scholar 

  40. Reginster JY, Seeman E, De Vernejoul MC et al (2005) Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: TROPOS study. J Clin Endocrinol Metab 90:2816–2822

    Article  CAS  PubMed  Google Scholar 

  41. Roux C, Reginster JY, Fechtenbaum J, Kolta S, Sawicki A, Tulassay Z et al (2006) Vertebral fracture risk reduction with strontium ranelate in women with postmenopausal osteoporosis is independent of baseline risk factors. J Bone Miner Res 21:536–542

    Article  CAS  PubMed  Google Scholar 

  42. Collette J, Bruyère O, Kaufman JM, Lorenc R, Felsenberg D, Spector TD et al (2010) Vertebral anti-fracture efficacy of strontium ranelate according to pre-treatment bone turnover. Osteoporos Int 21:233–241

    Article  CAS  PubMed  Google Scholar 

  43. Roux C, Fechtenbaum J, Kolta S, Isaia G, Andia JB, Devogelaer JP (2008) Strontium ranelate reduces the risk of vertebral fracture in young postmenopausal women with severe osteoporosis. Ann Rheum Dis 67:1736–1738

    Article  CAS  PubMed  Google Scholar 

  44. Arden N, editor. Risk factors for fracture. In: Osteoporosis. London, UK: Remedica; 2006. pp. 55–73

  45. Epstein S (2007) Is treatment of early postmenopausal women with bisphosphonates justified? Int J Clin Pract 61:963–971

    Article  CAS  PubMed  Google Scholar 

  46. Seeman E, Boonen S, Borgström F, Vellas B, Aquino J-P, Semler J et al (2010) Five years treatment with strontium ranelate reduces vertebral and nonvertebral fractures and increases the number and quality of remaining life years in women over 80 years of age. Bone 46:1038–1042

    Article  CAS  PubMed  Google Scholar 

  47. Boonen S, McClung MR, Eastell R, El-Hajj Fuleihan G (2004) Safety and efficacy of risedronate in reducing fracture risk in osteoporotic women aged 80 and older: implications for the use of antiresorptive agents in the old and oldest old. J Am Geriatr Soc 52:1832–1839

    Article  PubMed  Google Scholar 

  48. Boonen S, Marin F, Mellstrom D et al (2006) Safety and efficacy of teriparatide in elderly women with established osteoporosis: bone anabolic therapy from a geriatric perspective. J Am Geriatr Soc 54:782–789

    Article  PubMed  Google Scholar 

  49. Ringe JD, Doherty JG (2009) Absolute risk reduction in osteoporosis: assessing treatment efficacy by number needed to treat. Rheumatol Int [in press]

  50. Ismail AA, Cooper C, Felsenberg D et al (1999) Number and type of vertebral deformities: epidemiological characteristics and relation to back pain and height loss. European Vertebral Osteoporosis Study Group. Osteoporos Int 9:206–213

    Article  CAS  PubMed  Google Scholar 

  51. Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. Osteoporos Int 16:447–455

    Article  PubMed  Google Scholar 

  52. Marquis P, Roux C, Diaz-Curiel M (2007) Long-term beneficial effects of strontium ranelate on the quality of life in patients with vertebral osteoporosis (SOTI study). Osteoporos Int 18(suppl 1):S123

    Google Scholar 

  53. Marquis P, Roux C, De la Loge C, Diaz-Curiel M, Cormier C, Isaia G et al (2008) Strontium ranelate prevents quality of life impairment in postmenopausal women with established vertebral osteoporosis. Osteoporos Int 19:503–510

    Article  CAS  PubMed  Google Scholar 

  54. Feldstein A, Elmer PJ, Orwoll E, Herson M, Hillier T (2003) Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures: a gap in evidence-based practice guideline implementation. Arch Intern Med 163:2165–2172

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

S.B. has received consulting fees and/or research support from Amgen, Merck, Novartis, Procter & Gamble, Sanofi-Aventis, Servier, and Roche-GlaxoSmithKline.

Author information

Authors and Affiliations

  1. Leuven University Centre for Metabolic Bone Diseases and Division of Geriatric Medicine, Leuven, Belgium

    S. Boonen

Authors
  1. S. Boonen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Boonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boonen, S. Addressing the age-related needs of osteoporotic patients with strontium ranelate. Osteoporos Int 21 (Suppl 2), 415–423 (2010). https://doi.org/10.1007/s00198-010-1231-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-010-1231-4

Keywords

Search

Navigation