Strontium ranelate for the treatment of osteoporosis

Is useful, but changes in bone mineral density need careful interpretation

The successful treatment of osteoporosis is a relatively recent phenomenon. Although bisphosphonates are now established as the treatment of choice,1 this only came about with the publication in 1996 of the FIT alendronate trial.2 Nowadays the main treatment options are anti-resorptive agents that prevent bone breakdown. Most studies of these agents show good protection against fractures of the spine, while the more potent nitrogen containing bisphosphonates also show a reduction in non-vertebral fractures.1^–5 For patients with previous fractures, treatment with an anabolic agent that enhances bone formation is clearly preferable, and this is now possible since the introduction of 1-34 recombinant parathyroid hormone (PTH).6 However, the use of PTH is limited by its high cost and the need for subcutaneous self injection. Recently strontium ranelate has been licensed in the United Kingdom for the treatment of osteoporosis. Here we draw attention to the unusual effect of strontium treatment on bone mineral density and discuss the potential bonus that this effect can be used for assessing adherence to therapy.

The mechanism of action of …