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Polymeric strontium ranelate nona-hydrate.

ABSTRACT: The title compound, poly[[μ-aqua-tetra-aqua{μ-5-[bis-(carboxyl-atometh-yl)amino]-3-carboxyl-atomethyl-4-cyano-thio-phene-2-carboxyl-ato}distrontium(II)] tetra-hydrate], [Sr(2)(C(12)H(6)N(2)O(8)S)(H(2)O)(5)]·3.79H(2)O, crystallizes with nine- and eight-coordinated Sr(2+) cations. They are bound to seven of the eight ranelate O atoms and five of the water mol-ecules. The SrO(8) and SrO(9) polyhedra are inter-connected by edge-sharing, forming hollow layers parallel to (011). The layers are, in turn, inter-connected by ranelate anions, forming a metal-organic framework (MOF) structure with channels along the a axis. The four water mol-ecules not coordinated to strontium are located in these channels and hydrogen bonded to each other and to the ranelates. Part of the water H atoms are disordered. The compound dehydrates very easily and 0.210 (4) water mol-ecules out of nine were lost during crystal mounting causing additional disorder in the water structure.

SUBMITTER: Stahl K

PROVIDER: S-EPMC3099985 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectiveRecently, the European Medicines Agency reported that strontium ranelate increases myocardial infarction risk in postmenopausal women, 8.5 years after it was registered for use in osteoporosis. Unreported serious adverse events in clinical trials for other pharmaceuticals have been described in recent years. We assessed reporting of adverse events and fracture efficacy of strontium.MethodsWe compared data on adverse effects (myocardial infarction, venous thromboembolism and pulmonary embolism) and fracture efficacy of strontium in publicly available regulatory documents with data in publications retrieved from searching PubMed.ResultsWe identified 5 regulatory documents and 9 primary publications of 7 randomised, placebo-controlled trials of strontium that reported relevant data. We identified several areas of concern in these reports: the increased risk of myocardial infarction with strontium was not identified in a pivotal phase 3 clinical trial despite specific regulatory review of cardiovascular events; data on myocardial infarction were not included in any primary publication; increased risks of venous thromboembolism and pulmonary embolism with strontium were not reported in either of the phase 3 clinical trials; data on venous thromboembolism were reported in only 5 of 9 primary publications, data on pulmonary embolism in only 2 of 9 primary publications, and either was discussed in <50% of subsequent review articles. There were differences in participant numbers, fracture cases and venous thromboembolism cases between regulatory documents and primary publications. Based on all available data from primary publications and regulatory documents, the number of fractures prevented by strontium use is similar to the number of extra cases of venous thromboembolism, pulmonary embolism and myocardial infarction caused by strontium use.ConclusionsThe risks of strontium use are similar to the benefits. Full disclosure of the clinical trial data and regulatory documents would allow clinicians and their patients to decide whether use of the drug is worthwhile.

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Polymeric strontium ranelate nona-hydrate.

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