Strontium ranelate in the treatment of osteoporosis

Abstract

Strontium ranelate is a divalent cation that is capable of increasing bone formation and reducing bone resorption. This dual mechanism of action, dissociating remodelling, could be explained by its action at the level of the calcium-sensing receptor on the osteblast, stimulating the replication, differentiation and activity of the osteoblast and inhibiting the activity of the osteoclasts via receptor activator of nuclear factor-kB ligand (RANK-L). Strontium ranelate is effective in reducing the risk of vertebral fractures and nonvertebral fractures in menopausal patients. Strontium ranelate is effective in decreasing hip fracture rate in patients who are 74 years old with additional risk factors. Strontium ranelate has demonstrated its persistence for up to 8 years of therapy. The elimination of strontium from the bone after the termination of therapy is shown by the changes in biochemical markers, seen as early as 3 months after discontinuing therapy, suggesting that the drug is released rapidly. Strontium accumulation in bone tissue is progressive until a maximum at the third year of treatment. Strontium ranelate is administered orally as a suspension and is generally well tolerated. The incidence of adverse events is mild, and these do not significantly differ between strontium ranelate and placebo recipients. Strontium is a good option for the treatment of osteoporosis.