Abstract

Strontium ranelate is a medicine used to treat postmenopausal osteoporosis in women and osteoporosis in men. Preclinical data suggest its dual effect consisting of the control of bone resorption and promotion of bone formation. Administration of strontium ranelate leads to significant increase in the bone mass. Changes in bone density can be used to evaluate the adherence of patients as well as, in case of strontium ranelate, to estimate the fracture risk reduction. Clinical studies demonstrated its effect on reducing the risk of both vertebral and non-vertebral fractures, including fractures of the proximal femur. Currently, it is a second-line treatment of osteoporosis administered in case of intolerance, failure or contraindication of other therapy. Recently its cardiovascular safety was discussed. Contraindications of strontium ranelate in patients with ischemic heart disease, peripheral arterial disease, cerebrovascular disease or uncontrolled hypertension were added in 2013 to the wording of the Summary of Product Characteristics (SPC). Cohort and observational studies, however, did not clearly confirm the cardiovascular risk associated with administration of strontium ranelate. It is still a medicine indicated for treatment of osteoporosis with a favourable risk and benefit ratio.

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