Vertebral Fracture Risk Reduction With Strontium Ranelate in Women With Postmenopausal Osteoporosis Is Independent of Baseline Risk Factors
Christian Roux,Jean-Yves Reginster,Jacques Fechtenbaum,Sami Kolta,Andrzej Sawicki,Zsolt Tulassay,Giovanni Luisetto,José-Maria Padrino,David Doyle,Richard L. Prince,Patrice Fardellone,Ole Helmer Sørensen,Pierre J. Meunier +12 more
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Strontium ranelate (2 g/day) was studied in postmenopausal women and a reduction in incident vertebral fracture risk by 40% was shown after 3 years.Abstract:
Strontium ranelate (2 g/day) was studied in 5082 postmenopausal women. A reduction in incident vertebral fracture risk by 40% was shown after 3 years. This effect was independent of age, initial BMD, and prevalent vertebral fractures.
Introduction: Strontium ranelate is an orally active treatment able to decrease the risk of vertebral and hip fractures in osteoporotic postmenopausal women. The aim of this study was to assess the efficacy of strontium ranelate according to the main determinants of vertebral fracture risk: age, baseline BMD, prevalent fractures, family history of osteoporosis, baseline BMI, and addiction to smoking.
Materials and Methods: We pooled data of two large multinational randomized double-blind studies with a population of 5082 (2536 receiving strontium ranelate 2 g/day and 2546 receiving a placebo), 74 years of age on average, and a 3-year follow-up. An intention-to-treat principle was used, as well as a Cox model for comparison and relative risks.
Results: The treatment decreased the risk of both vertebral (relative risk [RR] = 0.60 [0.53–0.69] p < 0.001) and nonvertebral (RR = 0.85 [0.74–0.99] p = 0.03) fractures. The decrease in risk of vertebral fractures was 37% (p = 0.003) in women <70 years, 42% (p < 0.001) for those 70–80 years of age, and 32% (p = 0.013) for those ≥80 years. The RR of vertebral fracture was 0.28 (0.07–0.99) in osteopenic and 0.61 (0.53–0.70) in osteoporotic women, and baseline BMD was not a determinant of efficacy. The incidence of vertebral fractures in the placebo group increased with the number of prevalent vertebral fractures, but this was not a determinant of the effect of strontium ranelate. In 2605 patients, the risk of experiencing a first vertebral fracture was reduced by 48% (p < 0.001). The risk of experiencing a second vertebral fracture was reduced by 45% (p < 0.001; 1100 patients). Moreover, the risk of experiencing more than two vertebral fractures was reduced by 33% (p < 0.001; 1365 patients). Family history of osteoporosis, baseline BMI, and addiction to smoking were not determinants of efficacy.
Conclusions: This study shows that a 3-year treatment with strontium ranelate leads to antivertebral fracture efficacy in postmenopausal women independently of baseline osteoporotic risk factors.read more
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The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women.
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References
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Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis.
Robert M. Neer,Claude D. Arnaud,Jose R. Zanchetta,Richard L. Prince,Gregory A Gaich,Jean-Yves Reginster,Anthony B. Hodsman,Erik Fink Eriksen,Sophia Ish-Shalom,Harry K. Genant,Ouhong Wang,Bruce H. Mitlak +11 more
TL;DR: Treatment of postmenopausal osteoporosis with parathyroid hormone decreases the risk of vertebral and nonvertebral fractures; increases vertebral, femoral, and total-body bone mineral density; and is well tolerated.
Journal ArticleDOI
Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures
Dennis M. Black,Steven R. Cummings,David B. Karpf,Jane A. Cauley,Desmond E. Thompson,Michael C. Nevitt,Douglas C. Bauer,Harry K. Genant,William L. Haskell,Robert Marcus,Susan M. Ott,James C. Torner,Sara A. Quandt,Theodore F. Reiss,Kristine E. Ensrud +14 more
TL;DR: Among women with low bone mass and existing vertebral fractures, alendronate is well tolerated and substantially reduces the frequency of morphometric and clinical vertebra fractures, as well as other clinical fractures.
Journal ArticleDOI
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TL;DR: In this paper, epidemiological research was done and used to identify individuals at high risk of disabling fractures, thereby allowing careful allocation of expensive treatments to individuals most in need, which could potentially be as expensive as medical treatment of fractures.
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Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial
Bruce Ettinger,Dennis M. Black,Bruce H. Mitlak,Ronald Keith Knickerbocker,Thomas Nickelsen,Harry K. Genant,Claus Christiansen,Pierre D. Delmas,Jose R. Zanchetta,J. A. Stakkestad,Claus C. Glüer,Kathryn A. Krueger,Fredric J. Cohen,Stephen Eckert,Kristine E. Ensrud,Louis V. Avioli,Paul Lips,Steven R. Cummings +17 more
TL;DR: The Multiple Outcomes of Raloxifene Evaluation (MORE) study as mentioned in this paper evaluated the effect of raloxion hydrochloride therapy on risk of vertebral and non-vertebral fractures.
Journal ArticleDOI
Vertebral fracture assessment using a semiquantitative technique
TL;DR: The semiquantitative approach can be applied reliably in vertebral fracture assessment when performed using well‐defined criteria, and this approach was compared with a quantitative morpho‐metric approach.