Strontium ranelate, protelos

Strontium ranelate, protelos came to the European pharmaceutical market with great promise.  Research studies showed  benefits; bone density increased in post menopausal women.

1. In 2005 a research study " Strontium Ranelate as a new therapeutic agent for osteoporosis." by Imanishi Y, Nishizawa Y. Department of Metabolism, Endocrinilogy and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. was published in: Clinical Calcium. 

It stated that it:
" is a new chemical entity, which was recently demonstrated to reduce the fracture risk in osteoporosis patients. This unique compound has both stimulatory effect of osteoblast-mediated bone formation and inhibitory effect of osteoclast-mediated bone resorption, leading to increased bone mass."

2. From the UK came a study "Prevention of vertebral fractures by strontium ranelate in postmenopausal women with osteoporosis." by Compston J. Department of Medicine, Box 157, Addenbrooke's Hospital, Hills Road, Cambridge,UK. Osteoporos Int. 2005 Jan;16 Suppl 1:S4-6.

It said, in part: " In women with established osteoporosis there was a 41% reduction in vertebral fractures over 3 years' treatment [relative risk (RR) 0.59; 95% confidence interval (CI) 0.48-0.73; P<0.001]; significant reductions were also seen after only 1 year of treatment."

There were other studies and a report in the New England Journal of Medicine. 

3. Then reports of serious cardio side effects began to emerge and the European Union issues a warning that the drug should not be administered routinely - that it should only be used  to treat "severe osteoporosis in postmenopausal women at high risk of fracture and severe osteoporosis in men at increased risk of fracture. "  

New  studies on strontium ranelate:

Research on this drug has continued and its cardiac safety is one of the areas of continued research.

1. In 2014 International Osteoporosis published a study: Ischaemic cardiac events and use of strontium ranelate in postmenopausal osteoporosis: a nested case–control study in the CPRD  by C. Cooper, K. M. Fox, and J. S. Borer.

Summary: "We explored the cardiac safety of the osteoporosis treatment ... in the UK Clinical Practice Research Datalink. While known cardiovascular risk factors like obesity and smoking were associated with increased cardiac risk, use of strontium ranelate was not associated with any increase in myocardial infarction or cardiovascular death." (Italices mine)

Their Conclusions: "Analysis in the CPRD did not find evidence for a higher risk for cardiac events associated with the use of (of this drug)  in postmenopausal osteoporosis."

If you want to read the whole article, just click this  study of : Strontium ranelate safety.

2. Another study found that  "Filling of a Bone Defect and Improves the Material Level Properties of the Healing Bone" when this drug was used. The authors, Giovanna Zacchetti, Romain Dayer, [...], and Patrick Ammann, said that the drug: "...has been shown to in vitro decrease bone resorption and increase bone formation, and represents a potential agent with the capacity to accelerate bone defect filling."

3. Clinical cases in Bone Metabolism published a study, "Bone quality and bone strength: benefits of the bone-forming approach" by Giovanni Iolascon, Laura Frizzi, [...], and Francesca Gimigliano.

This article says, in part that  treatment " ... improves trabecular network and cortical thickness that will contribute to anti-fracture efficacy at both vertebral and non-vertebral sites." Additional article information

4. Finally, Mark J Bolland and Andrew Grey did a systematic review of all articles published and then wrote:  A comparison of adverse event and fracture efficacy data . . in regulatory documents and the publication.

They "assessed reporting of adverse events and fracture efficacy of strontium." by cmparing "data on adverse effects (myocardial infarction, venous thromboembolism and pulmonary embolism) and fracture efficacy . . . in publicly available regulatory documents with data in publications retrieved from searching PubMed."

They concluded: "The risks of strontium use are similar to the benefits. Full disclosure of the clinical trial data and regulatory documents would allow clinicians and their patients to decide whether use of the drug is worthwhile." If you want to read the complete study, put this url in your browser: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187454/

If you are in the EU, you need to speak with your health care provider for a prescription.  In the United States, it is NOT available by prescription but there are natural forms that can be found at:

Strontium ranelate is no longer manufactured in a number of countries. Do seek guidance if you are prescribed this drug.