A Cochrane review [Abstract] 1 included 4 studies with a total of 7253 subjects. A 37% reduction in vertebral fractures (RR 0.63, 95% CI 0.56, 0.71) and a 14% reduction in non-vertebral fractures (RR 0.86, 95% CI 0.75, 0.98) were demonstrated over three years with 2 g of strontium ranelate daily in a treatment population (3 trials). An increase in BMD was shown at all BMD sites after two to three years in both treatment and prophylasis (1 trial) populations. Additional data suggests that the risk of vascular and nervous system side-effects is slightly increased with taking 2 g of strontium ranelate daily over three to four years.
Comment: The quality of evidence is downgraded by methodological problems in the studies.
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