Journal
OSTEOPOROSIS INTERNATIONAL
Volume 26, Issue 6, Pages 1667-1671Publisher
SPRINGER LONDON LTD
DOI: 10.1007/s00198-015-3109-y
Keywords
Efficacy; Osteoporosis; Safety; Strontium ranelate; Treatment
Categories
Funding
- Servier
- Novartis
- Negma
- Lilly
- Wyeth
- Amgen
- GlaxoSmithKline
- Roche
- Merckle
- Nycomed
- NPS
- Theramex
- UCB
- Merck Sharp and Dohme
- Rottapharm
- IBSA
- Genevrier
- Teijin
- Teva
- Ebewee Pharma
- Zodiac
- Analis
- Novo Nordisk
- Bristol Myers Squibb
- Eli Lilly
- Merck Sharp Dohme
- Spa
- Stroder
- Alliance for Better Bone Health
- Ferring
- MSD
- Medtronic
- Roche diagnostics
- Pfizer
- Amgen Inc.
- Preglem
- Leon Farma
- Gynea
- Sandoz
- Bayer
- Merck Sharp
- Dohme
- Takeda
- Danone
- MRC [MC_U147585827] Funding Source: UKRI
- Medical Research Council [MC_U147585827, MC_U147585824, U1475000001, MC_UP_A620_1014, MC_UU_12011/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10082, NF-SI-0513-10085] Funding Source: researchfish
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Osteoporosis accounts for about 3% of total European health-care spending. The low proportion of costs for the pharmacological prevention of osteoporotic fracture means that it is highly cost saving, especially in patient with severe osteoporosis or patients who cannot take certain osteoporosis medications due to issues of contraindications or tolerability. Following recent regulatory changes, strontium ranelate is now indicated in patients with severe osteoporosis for whom treatment with other osteoporosis treatments is not possible, and without contraindications including uncontrolled hypertension, established, current or past history of ischaemic heart disease, peripheral arterial disease, and/or cerebrovascular disease. We review here today's evidence for the safety and efficacy of strontium ranelate. The efficacy of strontium ranelate in patients complying with the new prescribing information (i.e. severe osteoporosis without contraindications) has been explored in a multivariate analysis of clinical trial data, which concluded that the antifracture efficacy of strontium ranelate is maintained in patients with severe osteoporosis without contraindications and also demonstrated how the new target population mitigates risk. Strontium ranelate is therefore an important alternative in today's management of osteoporosis, with a positive benefit-risk balance, provided that the revised indication and contraindications are followed and cardiovascular risk is monitored. The bone community should be reassured that there remain viable alternatives in patients in whom treatment with other agents is not possible and protection against the debilitating effects of fracture is still feasible in patients with severe osteoporosis.
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