Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis

Purpose: The aim of this study was to compare and rank the efficacy of different drugs for bone mineral density (BMD) loss prevention at 1 year after total hip arthroplasty (THA) using a network meta-analysis (NMA) of randomized controlled trials (RCTs). Methods: A literature search was conducted ba...

Full description

Saved in:
Bibliographic Details
Main Authors: Akira Morita, Emi Kamono, Tadashi Oyama, Hyonmin Choe, Yutaka Inaba, Naomi Kobayashi
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Joint Surgery and Research
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S294970512400029X
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849761525882945536
author Akira Morita
Emi Kamono
Tadashi Oyama
Hyonmin Choe
Yutaka Inaba
Naomi Kobayashi
author_facet Akira Morita
Emi Kamono
Tadashi Oyama
Hyonmin Choe
Yutaka Inaba
Naomi Kobayashi
author_sort Akira Morita
collection DOAJ
description Purpose: The aim of this study was to compare and rank the efficacy of different drugs for bone mineral density (BMD) loss prevention at 1 year after total hip arthroplasty (THA) using a network meta-analysis (NMA) of randomized controlled trials (RCTs). Methods: A literature search was conducted based on the PRISMA statement. The searched databases included MEDLINE (through PubMed), Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). Only RCTs exploring the efficacy of currently available osteoporosis drugs in preventing periprosthetic BMD loss were included. A multivariate random-effects NMA was conducted to combine direct and indirect comparisons of agents using a frequentist consistency model. Regarding the efficacy rank, the frequentist analog to the surface under the cumulative ranking (SUCRA) probabilities, called the P-score, was used. Result: In total, 17 RCTs were extracted. According to the pairwise mean difference (95% confidence interval) in BMD change, the efficacy of teriparatide was highest in both zones 1 and 7. From the predicted treatment rankings for BMD changes, teriparatide was ranked as the best intervention in zone 1 (P-score ​= ​0.8844) and zone 7 (P-score ​= ​0.9044) Conclusions: The results suggest that teriparatide, zoledronic acid, alendronate, and etidronate may be options for the prevention of periprosthetic BMD loss in zones 1 and 7 ​at 1 year after THA.
format Article
id doaj-art-2ba3810bc9fd45289ac36cba6ca27003
institution DOAJ
issn 2949-7051
language English
publishDate 2025-03-01
publisher Elsevier
record_format Article
series Journal of Joint Surgery and Research
spelling doaj-art-2ba3810bc9fd45289ac36cba6ca270032025-08-20T03:06:00ZengElsevierJournal of Joint Surgery and Research2949-70512025-03-013181610.1016/j.jjoisr.2024.11.001Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysisAkira Morita0Emi Kamono1Tadashi Oyama2Hyonmin Choe3Yutaka Inaba4Naomi Kobayashi5Department of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, JapanDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, JapanDepartment of Orthopaedic Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, JapanDepartment of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan; Corresponding author. Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.Purpose: The aim of this study was to compare and rank the efficacy of different drugs for bone mineral density (BMD) loss prevention at 1 year after total hip arthroplasty (THA) using a network meta-analysis (NMA) of randomized controlled trials (RCTs). Methods: A literature search was conducted based on the PRISMA statement. The searched databases included MEDLINE (through PubMed), Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health Literature (CINAHL). Only RCTs exploring the efficacy of currently available osteoporosis drugs in preventing periprosthetic BMD loss were included. A multivariate random-effects NMA was conducted to combine direct and indirect comparisons of agents using a frequentist consistency model. Regarding the efficacy rank, the frequentist analog to the surface under the cumulative ranking (SUCRA) probabilities, called the P-score, was used. Result: In total, 17 RCTs were extracted. According to the pairwise mean difference (95% confidence interval) in BMD change, the efficacy of teriparatide was highest in both zones 1 and 7. From the predicted treatment rankings for BMD changes, teriparatide was ranked as the best intervention in zone 1 (P-score ​= ​0.8844) and zone 7 (P-score ​= ​0.9044) Conclusions: The results suggest that teriparatide, zoledronic acid, alendronate, and etidronate may be options for the prevention of periprosthetic BMD loss in zones 1 and 7 ​at 1 year after THA.http://www.sciencedirect.com/science/article/pii/S294970512400029XNetwork meta-analysisTotal hip arthroplastyBone mineral densityTeriparatideBisphosphonate
spellingShingle Akira Morita
Emi Kamono
Tadashi Oyama
Hyonmin Choe
Yutaka Inaba
Naomi Kobayashi
Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
Journal of Joint Surgery and Research
Network meta-analysis
Total hip arthroplasty
Bone mineral density
Teriparatide
Bisphosphonate
title Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
title_full Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
title_fullStr Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
title_full_unstemmed Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
title_short Determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty: A network meta-analysis
title_sort determining the most effective osteoporosis drug for bone mineral density loss in proximal area after total hip arthroplasty a network meta analysis
topic Network meta-analysis
Total hip arthroplasty
Bone mineral density
Teriparatide
Bisphosphonate
url http://www.sciencedirect.com/science/article/pii/S294970512400029X
work_keys_str_mv AT akiramorita determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis
AT emikamono determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis
AT tadashioyama determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis
AT hyonminchoe determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis
AT yutakainaba determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis
AT naomikobayashi determiningthemosteffectiveosteoporosisdrugforbonemineraldensitylossinproximalareaaftertotalhiparthroplastyanetworkmetaanalysis