Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate

J Clin Endocrinol Metab. 2007 Aug;92(8):3076-81. doi: 10.1210/jc.2006-2758. Epub 2007 Jun 12.


Objective: Our objective was to analyze the relationship between bone mineral density (BMD) changes and fracture incidence during 3-yr treatment with strontium ranelate.

Patients: Women from the strontium ranelate arm of the Spinal Osteoporosis Therapeutic Intervention study and the TReatment Of Peripheral OSteoporosis study were evaluated.

Outcome measures: The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based on written documentation.

Results: After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1-5%) and 2% (1-4%) reduction in risk of a new vertebral fracture, respectively. The 3-yr changes in femoral neck and total proximal femur BMD explained 76% and 74%, respectively, of the reduction in vertebral fractures observed during the treatment. Three-year changes in spine BMD were not statistically associated with the incidence of new vertebral fracture (P = 0.10). No significant associations were found between 3-yr changes in BMD and incidence of new nonvertebral fractures, but a trend was found for femoral neck BMD (P = 0.09) and for total proximal femur BMD (P = 0.07). An increase in femoral neck BMD after 1 yr was significantly associated with the reduction in incidence of new vertebral fractures observed after 3 yr (P = 0.04).

Conclusion: During 3-yr strontium ranelate treatment, an increase in femoral neck BMD was associated with a proportional reduction in vertebral fracture incidence.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Density / drug effects*
  • Calcium / therapeutic use
  • Double-Blind Method
  • Female
  • Femur / drug effects
  • Femur Neck / drug effects
  • Follow-Up Studies
  • Fractures, Bone / epidemiology
  • Fractures, Bone / prevention & control*
  • Humans
  • Logistic Models
  • Middle Aged
  • Organometallic Compounds / therapeutic use*
  • Osteoporosis / drug therapy
  • Risk Reduction Behavior
  • Spinal Fractures / epidemiology
  • Spine / drug effects
  • Thiophenes / therapeutic use*
  • Treatment Outcome
  • Vitamin D / therapeutic use


  • Organometallic Compounds
  • Thiophenes
  • strontium ranelate
  • Vitamin D
  • Calcium