There is currently no evidence available for the effect of strontium ranelate in reducing fracture risk in men and early postmenopausal women. However, there is evidence to support the effectiveness of strontium ranelate 2 g per day for the prevention of bone mineral density (BMD) loss in early postmenopausal women, both Caucasian and Asian,1,2 and men.3 There is strong evidence to support the effectiveness of strontium ranelate 2 g per day for reducing the risk of further osteoporotic fractures in postmenopausal women with prevalent fractures.1 Based on indirect comparisons, strontium ranelate appears to have similar efficacy to other therapies for spinal fractures apart from denosumab, where it is inferior.4 The effect of strontium may be partially blunted by prior bisphosphonates.5 Strontium may also be beneficial for fracture healing.6 Research suggests that strontium ranelate has a relatively greater effect on bone resorption than bone formation.7
Strontium ranelate was listed on the Pharmaceutical Benefits Scheme until 31 July 2016 for the treatment of women and men following a minimal trauma fracture and for the prevention of the first fracture in women 70 years of age or older with a T-score of ≤–3.0. Strontium ranelate is now available only on private prescription.