Our analysis indicates that the risk for cardiac events is increased in patients

with these contraindications. Indeed, in the case–control analysis of hospitalisation with MI, 12 % of the cases and 4 % of the controls had had a history of previous hospitalisation with MI before index date. Similar elevated risks were found for history of ischaemic heart disease (71 % in cases versus 24 % in controls), peripheral BIBW2992 artery disease (18 % in cases versus 7 % in controls), and cerebrovascular disease (23 % in cases versus 15 % in controls). In line with this, exclusion of patients with the contraindications from the pooled analyses of the randomised-controlled trials with strontium ranelate completely mitigated the risk for MI (data on file). The new contraindications for strontium ranelate are therefore expected to reduce any potential cardiovascular

risk associated with use of this treatment. Conclusion The results of this nested case–control study in the CPRD indicate no evidence for a higher risk of MI or cardiovascular death associated with the use of strontium ranelate in women treated for osteoporosis compared with non-use of this agent in routine medical practice in the UK. Acknowledgments The interpretation and conclusions contained in this report are those of the authors alone. This BMS202 study was funded by Servier. Study data were obtained from the CPRD under license from the UK MHRA to the Acceptability Data and Pharmacoepidemiology Department of Servier. The authors would like to thank Karine Marinier and Nicolas Deltour (Servier) for help with study design and conduct and statistical analysis. KF is an NIHR Senior Investigator supported by the NIHR Cardiovascular Biomedical Research Unit at the Royal Brompton Hospital. Conflicts of interest All authors have disclosed receiving fees, honoraria, and research grants from Servier.

References 1. Meunier PJ, Roux C, Seeman E et al (2004) The effects Resminostat of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350:459–468PubMedCrossRef 2. Reginster J-Y, Felsenberg D, Boonen S et al (2008) Effects of long-term strontium ranelate https://www.selleckchem.com/products/bay-11-7082-bay-11-7821.html treatment on the risk of nonvertebral and vertebral fractures in postmenopausal osteoporosis: results of a five-year, randomized, placebo-controlled trial. Arthritis Rheum 58:1687–1695PubMedCrossRef 3. Kaufman JM, Audran M, Bianchi G et al (2013) Efficacy and safety of strontium ranelate in the treatment of osteoporosis in men. J Clin Endocrinol Metab 98:592–601PubMedCrossRef 4. Reginster JY, Badurski J, Bellamy N et al (2013) Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial.