The type I error rate was set at 5% throughout. Statistical analyses were performed by Servier, and the study was organized under the control of independent advisory and steering committees. Safety evaluation Adverse events reported

spontaneously by patients or elicited during interview were recorded at each study visit. Blood and urinary calcium and blood phosphorus were assessed at each visit. Hematology and biochemistry tests were performed at M0, M6, M12, and then annually. Adverse events were reviewed by a safety committee, check details independent from the sponsor and from the other study committees. Results Patients A total of 1,649 patients were randomized: 828 to strontium ranelate and 821 to placebo. Of these, 1,149 patients (69.7%) completed the 4-year treatment period (strontium ranelate, 572 patients; placebo, 577 patients) and entered the fifth-year CX-6258 ic50 treatment-switch period. All placebo-treated patients were switched to strontium ranelate, and strontium ranelate-treated patients were randomized either to continue with strontium ranelate (SR/SR group, n = 288) or to switch to placebo (SR/placebo group, n = 284; Fig. 1). The EPZ015938 cell line proportion of randomized patients included in the ITT population at M48 was 87.6%. At M60, 1,070 patients completed

the study; however, 880 patients, representing 76.6% of those who entered the fifth year, were included in the ITT population at M60. The reasons for exclusion of these 190 patients were absence of treatment from M48 and absence of assessable lumbar BMD at baseline, M48, or after M48. Demographic and clinical characteristics of randomized patients are shown in Table 1. There were no relevant between-group differences. At entry to the fifth-year treatment-switch period, BMD values and corresponding T-scores were lower in patients on placebo during the 4-year Methisazone treatment period. In addition, a slight between-group difference was observed for patients having taken concomitant treatment for osteoporosis

during the study (4.2% and 2.1% patients in the SR/SR and SR/placebo groups versus 6.4% in the placebo/SR group). No other relevant between-group differences were observed for the remaining baseline characteristics. Table 1 Baseline characteristics at year 0 and at year 4 of the M48 and M60 ITT populations, expressed as mean ± standard deviation unless otherwise stated   Year 0 Year 4 Strontium ranelate, N = 719 Placebo, N = 726 SR/SR, N = 221 SR/placebo, N = 225 Placebo/SR, N = 434 Age, years 69.4 ± 7.2 69.3 ± 7.3 72.1 ± 6.9 72.1 ± 6.7 72.1 ± 6.9 Time since menopause (years) 22.1 ± 8.8 21.7 ± 8.8 24.5 ± 8.5 25.0 ± 8.7 24.3 ± 8.3 One or more prevalent vertebral fracture, n patients (%) 628 (87.5) 626 (86.3) 192 (86.9) 197 (87.6) 372 (86.1) Number of prevalent vertebral fractures 2.5 ± 2.0 2.5 ± 2.1 2.7 ± 2.2 2.8 ± 2.1 3.1 ± 2.7 Lumbar BMD (g/cm2) 0.731 ± 0.125 0.720 ± 0.118 0.849 ± 0.158* 0.862 ± 0.163* 0.717 ± 0.