Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial
https://doi.org/10.14412/1995-4484-2013-623-38
Abstract
Objective. Background Strontium ranelate is currently used for osteoporosis. The international, double-blind, randomised, placebo-controlled Strontium ranelate Efficacy in Knee OsteoarthrItis triAl evaluated its effect on radiological progression of knee osteoarthritis.
Methods. Patients with knee osteoarthritis (Kellgren and Lawrence grade 2 or 3, and joint space width (JSW) 2.5-5 mm) were randomly allocated to strontium ranelate 1 g/day (n=558), 2 g/day (n=566) or placebo (n=559). The primary endpoint was radiographical change in JSW (medial tibiofemoral compartment) over 3 years versus placebo. Secondary endpoints included radiological progression, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and knee pain. The trial is registered (ISRCTN41323372).
Results. The intention-to-treat population included 1371 patients. Treatment with strontium ranelate was associated with smaller degradations in JSW than placebo (1 g/day: -0.23 (SD 0.56) mm; 2 g/day: -0.27 (SD 0.63) mm; placebo:
-0.37 (SD 0.59) mm); treatment-placebo differences were 0.14 (SE 0.04), 95% CI 0.05 to 0.23, p<0.001 for 1 g/day and 0.10 (SE 0.04), 95% CI 0.02 to 0.19, p=0.018 for 2 g/day. Fewer radiological progressors were observed with
strontium ranelate (p<0.001 and p=0.012 for 1 and 2 g/day). There were greater reductions in total WOMAC score (p=0.045), pain subscore (p=0.028), physical function subscore (p=0.099) and knee pain (p=0.065) with strontium ranelate 2 g/day. Strontium ranelate was well tolerated.
Conclusions. Treatment with strontium ranelate 1 and 2 g/day is associated with a significant effect on structure in patients with knee osteoarthritis, and a beneficial effect on symptoms for strontium ranelate 2 g/day.
Additional supplementary data are published online only. To view these files please visit the journal online (http://dx.doi. org/10.1136/annrheumdis-2012-202231)
About the Authors
Jean-Yves Reginster
Department of Public Health Epidemiology and Health Economics, University of Liege,
Liege, Belgium
Belgium
Belgium
J Badurski
Centre of Osteoporosis and Osteoarticular Diseases, Bialystok, Poland
Poland
Poland
N Bellamy
Centre of National Research on Disability
(CONROD), University of Queensland, Herston, Queensland, Australia
Australia
Australia
W Bensen
DeGroot School of Medicine, McMaster
University Hamilton, Hamilton, Ontario, Canada
Canada
Canada
R Chapurlat
INSERM UMR 1033, Service de Rhumatologie et Pathologie Osseuse, Hospital Edouard Herriot, Universito de
Lyon, Lyon, France
France
France
X Chevalier
6Service de Rhumatologie, Hospital Henri
Mondor, CrОteil, France
France
France
C Christiansen
Synarc, Centre for Clinical and Basic Research (CCBR), Ballerup, Denmark
Denmark
Denmark
H Genant
Radiology, Medicine, Epidemiology and
Orthopedic Surgery, University of California, San Francisco and Synarc, San Francisco,
California, USA
United States
United States
F Navarro
Rheumatology Department, Hospital
Universitario Virgen Macarena, Sevilla, Spain
Spain
Spain
E Nasonov
State Institute of Rheumatology, Russian
Academy of Medical Sciences, Moscow, Russian Federation
Russian Federation
Russian Federation
P N Sambrook
Institute of Bone and Joint Research, Royal North Shore Hospital, St Leonards, NSW,
Australia
Australia
Australia
T D Spector
Department of Twin Research and Genetic
Epidemiology, Kings College London, St Thomas' Hospital, London, UK
United Kingdom
United Kingdom
C Cooper
MRC Lifecourse Epidemiology Unit, NIHR
Musculoskeletal Biomedical Research Unit, U University of Southampton, University of
Oxford, Oxford, UK
United Kingdom
United Kingdom
Review
For citations:
Reginster J., Badurski J., Bellamy N., Bensen W., Chapurlat R., Chevalier X., Christiansen C., Genant H., Navarro F., Nasonov E., Sambrook P.N., Spector T.D., Cooper C. Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial. Rheumatology Science and Practice. 2013;51(6):623-38. (In Russ.) https://doi.org/10.14412/1995-4484-2013-623-38
Views:
1014
Email this article 