Strontium Ranelate Prevents Progression of Thoracic Kyphosis in Postmenopausal Women With Osteoporosis: Presented at ASBMR

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Title: Strontium Ranelate Prevents Progression of Thoracic Kyphosis in Postmenopausal Women With Osteoporosis: Presented at ASBMR
URL: http://www.pslgroup.com/dg/22C7EE.htm
Doctor's Guide
September 16, 2008

By Louise Gagnon

MONTREAL -- September 16, 2008 -- Strontium ranelate can prevent the worsening of thoracic kyphosis in postmenopausal women with osteoporosis, according to a study presented here at the American Society for Bone and Mineral Research (ASBMR) 30th Annual Meeting.

Christian Roux, MD, PhD, Cochin Hospital and Descartes University, Paris, France, presented the study results in an oral presentation here on September 15.

Thoracic kyphosis can be caused by vertebral fractures, and by degenerative spine changes such as intervertebral disc space narrowing, deformities of the anterior part of the vertebrae, or reduced spinal muscles strength, Dr. Roux noted. Symptoms can range from back pain and decreased physical function to increased mortality.

Dr. Roux and colleagues conducted their study to determine whether strontium ranelate, which has proven effective in the prevention of vertebral fractures and peripheral fractures, would have an effect on the progression of thoracic kyphosis over a 3-year treatment period.

"We were interested to see if this was related to the structural effect of the drug," said Dr. Roux in an interview. "We looked at thoracic kyphosis, as a marker of degenerative changes in the spine."

The study enrolled 4,055 women who had participated in the Spinal Osteoporosis Therapeutic Intervention (SOTI) and Treatment of Peripheral Osteoporosis (TROPOS) studies.

The women underwent lateral radiographs of the thoracic and lumbar spine at baseline and each year for 3 years. At study entry, the women were a mean of 73.5 years old; they had a mean lumbar spine T-score of -3.06, a mean hip T-score of -2.97, and mean Kyphosis Index (KI) score of 25.4. A total of 2,038 women received strontium ranelate, and 2,017 received placebo.

Investigators defined the degree of thoracic kyphosis via a kyphosis index, which was expressed as a ratio. A higher index was indicative of more severe kyphosis, according to Dr. Roux.

Results showed that the increase in KI score was significantly reduced in patients who received strontium ranelate compared to those who received placebo (+3.71% vs +4.70%; P = .003).

When the researchers excluded patients who had either prevalent or incident thoracic vertebral fractures, they found that the index increased in all 1,193 patients over time, but that those patients who did not receive strontium ranelate therapy had statistically larger increases in KI (+2.72% vs +4.34%, respectively; P < .001).

"There was a progression of kyphosis in both groups, but there was less of progression in the treated group," Dr. Roux said, noting that there was a greater progression of thoracic kyphosis with or without incidence of vertebral fractures when patients went without strontium ranelate.

"Thoracic kyphosis deserves our attention for optimising the management of our osteoporosis patients," he said.

Dr. Roux noted that patients experienced adverse effects such as nausea or diarrhoea at the beginning of the study, and cautioned against using the drug in patients who have experienced previous thromboembolic events.

Funding for this study was provided by Servier Inc.

[Presentation title: Strontium Ranelate Prevents the Progression of Thoracic Kyphosis in Postmenopausal Women With Osteoporosis. Abstract 1241]

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