폐경 후 골다공증의 새로운 치료제 스트론튬 라넬레이트 = Strontium Ranelate A Novel Drug for Postmenopausal Osteoporosis

다국어 초록 (Multilingual Abstract)

Strontium ranelate is a novel drug for osteoporosis that has a duel effect on bone remodeling. Some mechanisms that underlie the beneficial effects of strontium ranelate on bone metabolism and strength have now been identified. Strontium ranelate induces pre-osteoblast replication, osteoblast differentiation, collagen type I synthesis, and bone matrix mineralization, probably through a calcium-sensing receptor- dependent mechanism. It also inhibits the differentiation and activity of osteoclasts by increasing the OPG/RANKL ratio. Preclinical studies have shown that this dual effect increases bone mass and improves bone microarchitecture and strength in intact rodents, as well as prevents bone loss in animals with osteopenia. Thus, strontium ranelate rebalances bone turnover in favor of enhanced bone strength. Treatment efficacy with strontium ranelate has been assessed in postmenopausal women in two large, double-blind, placebo- controlled clinical trials. During these clinical trials, strontium ranelate increased bone mineral density by 14.4% in the lumbar spine and by 8.2∼8.3% in the femoral neck at 36 months, compared with placebo. During the same period, strontium ranelate decreased the risk of vertebral fractures and non-vertebral fractures by 41% and 16%, respectively. Moreover, it showed efficacy in the different subgroups of patients with postmenopausal osteoporosis. In the context of clinical trials, nausea and diarrhea were the most common adverse events occurring within the first three months. Nevertheless, there were no significant differences between the groups with respect to the incidence of serious adverse events.