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Vertebral anti-fracture efficacy of strontium ranelate according to pre-treatment bone turnover.

Collette J, Bruyère O, Kaufman JM, Lorenc R, Felsenberg D, Spector TD, Diaz-Curiel M, Boonen S, Reginster JY - Osteoporos Int (2009)

Bottom Line: In the strontium ranelate group, incidences of vertebral fracture did not differ significantly across BTO tertiles.Risk reduction did not differ among tertiles (b-ALP: p = 0.513; sCTX: p = 0.290).Strontium ranelate offers clinical benefits to women across a wide range of metabolic states.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Biology, Bone and Cartilage Markers Laboratory, University of Liège, Liège, Belgium. J.Collette@chu.ulg.ac.be

ABSTRACT

Unlabelled: Osteoporotic post-menopausal women patients in two randomised trials comparing the anti-fracture efficacy of strontium ranelate with placebo were separated into tertiles according to their baseline levels of biochemical markers of bone formation and resorption. The vertebral anti-fracture efficacy of strontium ranelate was shown to be independent of baseline bone turnover levels.

Introduction: Bone turnover (BTO) levels vary among women at risk of osteoporotic fracture. Strontium ranelate is an anti-osteoporotic treatment increasing bone formation and reducing bone resorption. It was hypothesised that its anti-fracture efficacy would be independent of baseline BTO levels.

Methods: Post-menopausal women with osteoporosis from two pooled studies were stratified in tertiles according to baseline levels of two BTO markers: bone-specific alkaline phosphatase (b-ALP, n = 4995) and serum C-telopeptide cross-links (sCTX, n = 4891). Vertebral fracture risk was assessed over 3 years with strontium ranelate 2 g/day or placebo.

Results: In the placebo group, relative risk of vertebral fractures increased with BTO tertiles by 32% and 24% for patients in the highest tertile for b-ALP and CTX, respectively, compared to those in the lowest tertile. In the strontium ranelate group, incidences of vertebral fracture did not differ significantly across BTO tertiles. Significant reductions in vertebral fractures with strontium ranelate were seen in all tertiles of both markers, with relative risk reductions of 31% to 47% relative to placebo. Risk reduction did not differ among tertiles (b-ALP: p = 0.513; sCTX: p = 0.290).

Conclusion: The vertebral anti-fracture efficacy of strontium ranelate was independent of baseline BTO levels. Strontium ranelate offers clinical benefits to women across a wide range of metabolic states.

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Related in: MedlinePlus

Incidence of vertebral fractures over 3 years according to tertiles of b-ALP (upper panel) and sCTX (lower panel). SR strontium ranelate, PL placebo
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Fig1: Incidence of vertebral fractures over 3 years according to tertiles of b-ALP (upper panel) and sCTX (lower panel). SR strontium ranelate, PL placebo

Mentions: Strontium ranelate was associated with a reduction in the relative risk of vertebral fracture, relative to placebo, of 40% (RR = 0.60, 95% CI [0.53–0.70], p < 0.001). When patients were stratified by tertiles of baseline levels of bone turnover markers, significant RR reductions with strontium ranelate were seen in each tertile of b-ALP (31%, 42% and 42% for tertiles 1, 2 and 3, respectively). The same results were observed for tertiles of sCTX, with RR reductions of 37%, 32% and 47% for tertiles 1 to 3, respectively (Table 4, Fig. 1). The magnitudes of the treatment effects were not significantly different between tertiles (interaction test p = 0.513 for b-ALP tertiles, p = 0.290 for sCTX tertiles). Results were similar after adjustment on lumbar BMD.Table 4


Vertebral anti-fracture efficacy of strontium ranelate according to pre-treatment bone turnover.

Collette J, Bruyère O, Kaufman JM, Lorenc R, Felsenberg D, Spector TD, Diaz-Curiel M, Boonen S, Reginster JY - Osteoporos Int (2009)

Incidence of vertebral fractures over 3 years according to tertiles of b-ALP (upper panel) and sCTX (lower panel). SR strontium ranelate, PL placebo
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2801841&req=5

Fig1: Incidence of vertebral fractures over 3 years according to tertiles of b-ALP (upper panel) and sCTX (lower panel). SR strontium ranelate, PL placebo
Mentions: Strontium ranelate was associated with a reduction in the relative risk of vertebral fracture, relative to placebo, of 40% (RR = 0.60, 95% CI [0.53–0.70], p < 0.001). When patients were stratified by tertiles of baseline levels of bone turnover markers, significant RR reductions with strontium ranelate were seen in each tertile of b-ALP (31%, 42% and 42% for tertiles 1, 2 and 3, respectively). The same results were observed for tertiles of sCTX, with RR reductions of 37%, 32% and 47% for tertiles 1 to 3, respectively (Table 4, Fig. 1). The magnitudes of the treatment effects were not significantly different between tertiles (interaction test p = 0.513 for b-ALP tertiles, p = 0.290 for sCTX tertiles). Results were similar after adjustment on lumbar BMD.Table 4

Bottom Line: In the strontium ranelate group, incidences of vertebral fracture did not differ significantly across BTO tertiles.Risk reduction did not differ among tertiles (b-ALP: p = 0.513; sCTX: p = 0.290).Strontium ranelate offers clinical benefits to women across a wide range of metabolic states.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Biology, Bone and Cartilage Markers Laboratory, University of Liège, Liège, Belgium. J.Collette@chu.ulg.ac.be

ABSTRACT

Unlabelled: Osteoporotic post-menopausal women patients in two randomised trials comparing the anti-fracture efficacy of strontium ranelate with placebo were separated into tertiles according to their baseline levels of biochemical markers of bone formation and resorption. The vertebral anti-fracture efficacy of strontium ranelate was shown to be independent of baseline bone turnover levels.

Introduction: Bone turnover (BTO) levels vary among women at risk of osteoporotic fracture. Strontium ranelate is an anti-osteoporotic treatment increasing bone formation and reducing bone resorption. It was hypothesised that its anti-fracture efficacy would be independent of baseline BTO levels.

Methods: Post-menopausal women with osteoporosis from two pooled studies were stratified in tertiles according to baseline levels of two BTO markers: bone-specific alkaline phosphatase (b-ALP, n = 4995) and serum C-telopeptide cross-links (sCTX, n = 4891). Vertebral fracture risk was assessed over 3 years with strontium ranelate 2 g/day or placebo.

Results: In the placebo group, relative risk of vertebral fractures increased with BTO tertiles by 32% and 24% for patients in the highest tertile for b-ALP and CTX, respectively, compared to those in the lowest tertile. In the strontium ranelate group, incidences of vertebral fracture did not differ significantly across BTO tertiles. Significant reductions in vertebral fractures with strontium ranelate were seen in all tertiles of both markers, with relative risk reductions of 31% to 47% relative to placebo. Risk reduction did not differ among tertiles (b-ALP: p = 0.513; sCTX: p = 0.290).

Conclusion: The vertebral anti-fracture efficacy of strontium ranelate was independent of baseline BTO levels. Strontium ranelate offers clinical benefits to women across a wide range of metabolic states.

Show MeSH
Related in: MedlinePlus