Skeleton Pirate

Skeleton Pirate
Artist: LindaB


Have you experienced, or read about, negative, and even dangerous, side effects from Fosamax (alendronate), Boniva (ibandronate), Actonel (risedronate), and other bisphosphonates prescribed for osteoporosis? If you have, then rest assured there is a safe, effective treatment for this condition. Strontium, primarily in the form of strontium citrate, is taken orally once a day.

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Monday, May 12, 2014

Fracture Healing with Current and Emerging Osteoporosis Therapies

The failure rate for fracture fixation in patients with osteoporosis has been estimated to be 10–25%. An agent that improves bone repair, fracture healing, and fixation of surgical hardware would be beneficial in the management of fractures. A consensus statement released by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) addressed fracture healing with current and emerging osteoporosis therapy.

The ESCEO concluded that bisphosphonates (Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid, and Zometa) and raloxifene (Evista) did not impair fracture healing.

Preclinical studies and several case reports suggested that strontium ranelate might enhance fracture healing.

Studies with teriparatide (Forteo) had mixed results, but overall were consistent with a beneficial effect on fracture healing.

Clinical trials with denosumab (Prolia) have shown no adverse effects on fracture healing.

Sclerostin monoclonal antibody therapy has been shown to enhance fracture healing in rats and cynomolgus monkeys. Although several phase II studies to investigate the effects of romosozumab (an antisclerostin therapy) on fracture healing in humans have been conducted [ identifiers: NCT00907296, NCT01081678], there is currently no ongoing effort to pursue regulatory approval of this agent for acceleration of fracture healing.

You will note that, among the current therapies, only strontium ranelate, which is not available in the USA or Canada, and teriparatide may enhance fracture healing. I believe strontium citrate has the same beneficial effect on fracture healing because it is the strontium that increases bone mineral density and improves bone microarchitecture. 

Role of Sclerostin in Bone and Cartilage and Its Potential as a Therapeutic Target in Bone Diseases, E. Michael Lewiecki, MD, FACP, FACE, Ther Adv Musculoskel Dis. 2014;6(2):48-57.

Goldhahn, J., Feron, J., Kanis, J., Papapoulos, S., Reginster, J., Rizzoli, R. et al. (2012) Implications for fracture healing of current and new osteoporosis treatments: an ESCEO consensus paper. Calcif TissueInt 90: 343–353.


Thiago daLuz said...

I immediately appreciate this blog more for having a skeleton pirate at the top. That being said, I was also really interested to read about these osteoporosis therapies. I'm glad to hear that new methods are still emerging. Thiago |

BoneLady said...

To: Thiago daLuz,

I'm glad you like the skeleton pirate and my post on osteoporosis therapies. I am also glad to know new therapies are emerging. Some day those with osteoporosis will have more treatment options.

Are you affiliated with the Women's Health Center of Greenville? I rarely allow links to other sites unless they are legitimate and on topic. Although I am not familiar with the center, its website shows it provides OB/GYN and other women's services in Greenville, NC.

Actonel said...

Much needed information about osteoporosis therapies.Thnks!

Wandering Skeleton

Wandering Skeleton
Artist: Joel Hoekstra

Osteoporotic Bone

Osteoporotic Bone

How Strontium Builds Bones

Strontium is a mineral that tends to accumulate in bone. Studies have shown that oral doses of strontium are a safe and effective way to prevent and reverse osteoporosis. Doses of 680 mg per day appear to be optimal. See my "For More Information About Strontium" links section.

Osteoporosis is caused by changes in bone production. In healthy young bones there is a constant cycle of new bone growth and bone removal. With age, more bone is removed and less new bone is produced. The bones become less dense and thus more fragile.

Scientists believe that strontium works in two ways. It may stimulate the replication of pre-osteoblasts, leading to an increase in osteoblasts (cells that build bone). Strontium also directly inhibits the activity of osteoclasts (cells that break down bone). The result is stronger bones.

When taking strontium, be sure to take 1200 mg calcium, 1000 IU vitamin D3, and 500 mg magnesium daily. It is best to take strontium late at night on an empty stomach. Calcium and strontium may compete with each other for absorption if taken together.