Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis
ABSTRACT: PURPOSE: The purpose of this study was to estimate the benefits and drawbacks of bisphosphonates in the treatment of osteoporosis and osteopenia in middle-aged and elderly individuals.METHODS: We searched Ovid MEDLINE, Embase, the Web of Science, and Cochrane library databases for randomiz...
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| Format: | Article |
| Language: | English |
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KeAi Communications Co., Ltd.
2022-03-01
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| Series: | Nano TransMed |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2790676023000419 |
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| author | Qin Hu Xun Pan Yaxian Liang Hongdan Xu Jinning Gu Wenting She Huixu Xie |
| author_facet | Qin Hu Xun Pan Yaxian Liang Hongdan Xu Jinning Gu Wenting She Huixu Xie |
| author_sort | Qin Hu |
| collection | DOAJ |
| description | ABSTRACT: PURPOSE: The purpose of this study was to estimate the benefits and drawbacks of bisphosphonates in the treatment of osteoporosis and osteopenia in middle-aged and elderly individuals.METHODS: We searched Ovid MEDLINE, Embase, the Web of Science, and Cochrane library databases for randomized clinical trials (RCTs) evaluating the effects of bisphosphonates and performed a network meta-analysis to summarize the direct and indirect evidence on the efficacy and safety of bisphosphonate therapy in middle-aged and elderly individuals with osteoporosis or osteopenia.RESULTS: A total of 14 RCTs (7,769 patients with osteoporosis or osteopenia, median age, 67 years, median follow-up, 27 months) were included in this network meta-analysis. Of these, 8, 10, 9, and 6 RCTs provided outcomes on bone mineral density changes, clinical fracture rates, vertebral fracture rates, and nonvertebral fracture rates, respectively. Regarding the primary efficacy outcome, there was a 97% probability for alendronate to be the most effective treatment approach for increasing bone mineral density and an 84% probability for zoledronate to be the most effective treatment approach for clinical fractures. Regarding vertebral fractures and safety outcomes, zoledronate showed an odds ratio (OR) of 0.45 (95% confidence intervals [CI], 0.30-0.69) relative to placebo. For nonvertebral fractures, the OR of zoledronate relative to placebo was 0.51 (95% CI 0.29-0.90).CONCLUSIONS: This study revealed that alendronate was effective in increasing bone mineral density in middle-aged individuals and that zoledronate was a safe treatment option for osteoporosis and osteopenia, conferring a low incidence of fracture. However, further clinical studies are needed to confirm these results. |
| format | Article |
| id | doaj-art-b667e3474f3941f194e57375de27a2b7 |
| institution | Kabale University |
| issn | 2790-6760 |
| language | English |
| publishDate | 2022-03-01 |
| publisher | KeAi Communications Co., Ltd. |
| record_format | Article |
| series | Nano TransMed |
| spelling | doaj-art-b667e3474f3941f194e57375de27a2b72024-11-12T05:22:06ZengKeAi Communications Co., Ltd.Nano TransMed2790-67602022-03-0111e9130003Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysisQin Hu0Xun Pan1Yaxian Liang2Hongdan Xu3Jinning Gu4Wenting She5Huixu Xie6Faculty of Dentistry, Periodontology, The University of Hong Kong, Hong Kong, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaState Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaState Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaState Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaState Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaCenter of Stomatology, Renmin Hospital of Wuhan University, Wuhan 430061, ChinaState Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, ChinaABSTRACT: PURPOSE: The purpose of this study was to estimate the benefits and drawbacks of bisphosphonates in the treatment of osteoporosis and osteopenia in middle-aged and elderly individuals.METHODS: We searched Ovid MEDLINE, Embase, the Web of Science, and Cochrane library databases for randomized clinical trials (RCTs) evaluating the effects of bisphosphonates and performed a network meta-analysis to summarize the direct and indirect evidence on the efficacy and safety of bisphosphonate therapy in middle-aged and elderly individuals with osteoporosis or osteopenia.RESULTS: A total of 14 RCTs (7,769 patients with osteoporosis or osteopenia, median age, 67 years, median follow-up, 27 months) were included in this network meta-analysis. Of these, 8, 10, 9, and 6 RCTs provided outcomes on bone mineral density changes, clinical fracture rates, vertebral fracture rates, and nonvertebral fracture rates, respectively. Regarding the primary efficacy outcome, there was a 97% probability for alendronate to be the most effective treatment approach for increasing bone mineral density and an 84% probability for zoledronate to be the most effective treatment approach for clinical fractures. Regarding vertebral fractures and safety outcomes, zoledronate showed an odds ratio (OR) of 0.45 (95% confidence intervals [CI], 0.30-0.69) relative to placebo. For nonvertebral fractures, the OR of zoledronate relative to placebo was 0.51 (95% CI 0.29-0.90).CONCLUSIONS: This study revealed that alendronate was effective in increasing bone mineral density in middle-aged individuals and that zoledronate was a safe treatment option for osteoporosis and osteopenia, conferring a low incidence of fracture. However, further clinical studies are needed to confirm these results.http://www.sciencedirect.com/science/article/pii/S2790676023000419bone lossbisphosphonatesfracturebone mineral densitynano-drug delivery system |
| spellingShingle | Qin Hu Xun Pan Yaxian Liang Hongdan Xu Jinning Gu Wenting She Huixu Xie Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis Nano TransMed bone loss bisphosphonates fracture bone mineral density nano-drug delivery system |
| title | Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis |
| title_full | Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis |
| title_fullStr | Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis |
| title_full_unstemmed | Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis |
| title_short | Comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age: A systematic review and network meta-analysis |
| title_sort | comparative efficacy and safety of bisphosphonate therapy for bone loss in individuals after middle age a systematic review and network meta analysis |
| topic | bone loss bisphosphonates fracture bone mineral density nano-drug delivery system |
| url | http://www.sciencedirect.com/science/article/pii/S2790676023000419 |
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