A small point that is not merely a detail: the team from Liége was at the front line of this study, from the beginning of the design of the protocol, leading up to its compilation with the doctors of Servier. Prof. Jean-Yves Reginster was given the role of President of the Scientific Committee for the study.  Finally, it was the team from Liége who also created the doses for the serum and urinary markers for the remodeling of the bone and cartilage, the analysis of which is still in progress.

 As the European Medications Agency had recommended, the secondary criteria for this study focused on other points. One of these consisted in counting the number of people considered to be “responders”. This word covers those for whom the progression of joint narrowing has not reached a pre-determined threshold considered to be highly predictive of the need for surgery, within an average period (5 years), resulting in surgery to replace the joint with a prosthetic. Different thresholds were proposed in the literature and all of them were analyzed in this study. In addition, the researchers also concentrated on the job of assessing and analyzing the benefits of treatment for the symptoms of the disease. To succeed in this, they used the WOMAC  scale (Western Mac Master Ontario) : this questionnaire of 24 questions makes it possible to measure the severity of symptoms by assessing the pain felt at different times of the day or during the different actions of daily life, such as putting on socks or getting out of bed.  “This index is composed of three dimensions: pain, stiffness and joint function”, adds Prof. Reginster. 

A three-year calm

The rate of early termination of the treatment after three years has risen to 42 %, a level that is exactly in accordance with what was published in the international literature for all studies of the same type conducted on the arthrosis of the lower members in a placebo-controlled trial. “For patients who continued their treatment, we noticed a therapeutic compliance higher than 90 %, which confirms, as was shown in the case of osteoporosis, the excellent tolerance of strontium ranelate in patients treated by this medication. In terms of tolerance, no statistically significant difference was observed between the placebo and the two doses of strontium ranelate for musculo-skeletal problems, infections, gastro-intestinal problems and troubles of the nervous system, vascular troubles or even cutaneous problems. No DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms, a very strong reaction to a medication leading to, amongst others, severe cutaneous eruptions) was described”, assures Prof. Reginster.

The results are revealed

The work published in Current Medical Research & Opinion detailed the process, the objectives and the conditions imposed for the study of strontium ranelate in arthrosis. On the other hand, it did not indicate the results obtained creating suspense. The suspense was lifted when the results were released last March in Bordeaux, during the European conference on bone health, an important congress bringing together specialists and researchers.
 
For the main objective, it was a success, “After three years of study, the two doses of strontium ranelate made it possible to achieve a significant statistical reduction in the progression of joint space narrowing in relation to the group having a placebo”, states Prof. Reginster. In fact the loss of cartilage observed was reduced by 27 % in the group taking 2 grams daily. In other words, these patients gained one year over the three years. This result is far from insignificant. Indeed, it signifies that, for the first time, the deterioration of tissue has been partly halted.

But if this effect is important, it is also because it should make it possible to save time and defer the moment when, due to their pain and immobility, patients are obliged to have an operation to replace their joints by a prosthetic. In young people, like sportspeople, who are confronted by such a prospect, any time-gain is particularly welcome. All the more so because if we replace a knee at 70 years, it is undoubtedly for life, while if the operation is done at 40 it will probably be necessary to operate again fifteen or so years later.