Strontium ranelate—A promising therapeutic principle in osteoporosis

INSERM, UMR 1033, F-69372 Lyon, France.
Journal of Trace Elements in Medicine and Biology (Impact Factor: 2.37). 05/2012; 26(2-3):153-6. DOI: 10.1016/j.jtemb.2012.03.013
Source: PubMed


Strontium ranelate (2g/day) appears to be a safe and efficient treatment of osteoporosis (OP), reducing the risks of both vertebral and non-vertebral fractures (including hip) in a wide variety of patients. Thus, the agent can now be considered as a first-line option to treat women at risk of OP fractures, whatever their age and the severity of the disease. A long-term treatment with strontium ranelate in OP women leads to a continued increase in bone mineral density at spine and hip levels, and a sustained antifracture efficacy. The mode of action of strontium ranelate involves a dissociation between bone resorption and formation, as the bone formation rate is increased and not influenced by the antiresorptive action of the agent. Strontium is heterogeneously distributed in bone tissue: it is absent from old bone tissue and is exclusively present in bone formed during the treatment. Total area containing strontium in bone tissue increases during treatment, although the focal bone strontium content is constant. Whatever the duration of treatment and the content of strontium in bone, the degree of mineralization is maintained in a normal range. Furthermore, no change at crystal level is detected up to 3 years of treatment.

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Available from: Georges Boivin, Oct 06, 2014
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    • "It has been also shown that strontium-containing Ti–6Al–4V implants improved osseointegration, by enhancing differentiation of osteoblastic cells [29]. Moreover, strontium ranelate has been demonstrated to reduce the risk of vertebral fracture in postmenopausal women [30] [31]. These beneficial effects of strontium ion on promoting bone formation are related to its capability to increase new bone formation, contribute to bone remodeling and decrease bone resorption [32]. "
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    • "The impact of exogenous metals on the mineralization process, and further on bone health, is a matter of concern in many cases. For instance, in vivo, strontium derivatives are promising agents for the treatment of osteoporosis [6] [7] and magnesium deficiency may disrupt bone metabolism [8]. The need to perfectly control the long term tolerance of prosthetic metal implants has led to several in vitro studies, which are justified by their potential to release metallic ions at the bone level. "
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    • "The anti-osteoporotic drug strontium ranelate can stimulate bone regeneration (Dahl et al., 2001; Marie et al., 2001; Marie, 2006; Boivin et al., 2012) by increasing the number of pre-osteoblast cells and inhibiting bone resorption by osteoclast cells (Marie, 2006; Bonnelye et al., 2008). Mineral density and the mechanical properties of osteoporotic bone tissue could also be positively affected by strontium ranelate treatment, decreasing the risk of bone fractures (Ammann et al., 2004, 2007; Reginster et al., 2008). "
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