Chair and Department of Nephrology, Dialysotherapy and Internal Diseases, Warsaw Medical University, Warszawa, Poland.
Endokrynol Pol. 2011 Jan-Feb;62(1):65-72.
Strontium ranelate is one of the first-line agents with proven anti-fracture activity used in the therapy of post-menopausal osteoporosis. Its mechanism of action makes it, however, different from other drugs, since it simultaneously stimulates two reverse processes: bone formation and bone resorption. The action of the agent depends on various mechanisms, including the activation of calcium receptors, localised on osteoblasts and osteoclasts, and on the influence on the OPG/RANKL system. The drug effectively prevents spinal, hip and extravertebral fractures. The agent's anti-fracture efficacy within the spine does not depend on the patient's age, or on base BMD values, or on the concentration of bone metabolism markers. As to the anti-fracture efficacy in the hip, it concerns women with an increased bone fracture risk. Strontium ranelate increases bone mineral density within the lumbar spine and the hip, decreases the concentrations of bone resorption markers, and increases the concentrations of bone formation markers. The drug is administered in a daily 2.0 g oral dose. This paper presents indications to therapy with strontium ranelate, specifying also its side effects and contraindications. We compare the anti-fracture efficacy of strontium ranelate to the efficacy of other agents of proven anti-fracture activity, based on published clinical studies.
雷奈酸锶是治疗绝经后骨质疏松症的一线药物之一，具有明确的抗骨折活性。然而，其作用机制与其他药物不同，因为它同时刺激两种相反的过程：骨形成和骨吸收。该药物的作用取决于多种机制，包括激活钙受体，这些钙受体定位于成骨细胞和破骨细胞上，以及对 OPG/RANKL 系统的影响。该药物可有效预防脊柱、髋部和椎体外骨折。该药物在脊柱中的抗骨折疗效不依赖于患者的年龄、基础 BMD 值或骨代谢标志物的浓度。至于髋部的抗骨折疗效，它与骨折风险增加的女性有关。雷奈酸锶可增加腰椎和髋部的骨密度，降低骨吸收标志物的浓度，并增加骨形成标志物的浓度。该药物每天口服 2.0 g。本文介绍了雷奈酸锶治疗的适应证，并特别说明了其副作用和禁忌证。我们根据已发表的临床研究，将雷奈酸锶的抗骨折疗效与其他具有明确抗骨折活性的药物进行了比较。
