Cargando…
Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials
BACKGROUND: Alendronate has been used to prevent or treat glucocorticoid-induced osteoporosis (GIO), data regarding its efficacy are inconsistent. We conducted the current systematic review and meta-analysis to evaluate both efficacy and safety of alendronate in the treatment of GIO. METHODS: PubMed...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211897/ https://www.ncbi.nlm.nih.gov/pubmed/30334952 http://dx.doi.org/10.1097/MD.0000000000012691 |
_version_ | 1783367428268359680 |
---|---|
author | Wang, Ya-Kang Zhang, Yu-min Qin, Si-Qing Wang, Xu Ma, Tao Guo, Jian-Bin Zhu, Chao Luo, Zhuo-Jing |
author_facet | Wang, Ya-Kang Zhang, Yu-min Qin, Si-Qing Wang, Xu Ma, Tao Guo, Jian-Bin Zhu, Chao Luo, Zhuo-Jing |
author_sort | Wang, Ya-Kang |
collection | PubMed |
description | BACKGROUND: Alendronate has been used to prevent or treat glucocorticoid-induced osteoporosis (GIO), data regarding its efficacy are inconsistent. We conducted the current systematic review and meta-analysis to evaluate both efficacy and safety of alendronate in the treatment of GIO. METHODS: PubMed, Embase, the Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing Databases were searched up through March 1, 2018. Randomized controlled trials (RCTs) involving patients which received alendronate treatment were included. Outcome measures were bone mineral density (BMD) changes, bone fractures, and adverse reactions. Data from the individual studies were pooled using random or fixed effect models based on heterogeneity. Effect size was reported as standardized mean differences (SMD) for continuous outcomes and pooled odds ratios (OR) for dichotomous outcomes, with 95% confidence interval (CI). RESULTS: Overall, 10 studies involving 1002 patients were included in the present investigation. Alendronate treatment significantly increased BMD of the lumbar spine and femoral neck during 6 to 24 months. These beneficial effects were apparent at 12 months after treatment for the lumbar spine but not the femoral neck BMD. Alendronate treatment did not significantly change fracture risk nor induce significant differences in adverse gastrointestinal effects. CONCLUSION: Alendronate significantly increases BMD of the lumbar spine and femoral neck in patients with GIO, but does not appear to reduce the risk of fractures. As relatively insufficient data regarding the GIO fracture incidence has been reported, more RCTs need to be carried out to determine the efficacy of alendronate in the prevention of GIO fracture. |
format | Online Article Text |
id | pubmed-6211897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-62118972018-11-27 Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials Wang, Ya-Kang Zhang, Yu-min Qin, Si-Qing Wang, Xu Ma, Tao Guo, Jian-Bin Zhu, Chao Luo, Zhuo-Jing Medicine (Baltimore) Research Article BACKGROUND: Alendronate has been used to prevent or treat glucocorticoid-induced osteoporosis (GIO), data regarding its efficacy are inconsistent. We conducted the current systematic review and meta-analysis to evaluate both efficacy and safety of alendronate in the treatment of GIO. METHODS: PubMed, Embase, the Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing Databases were searched up through March 1, 2018. Randomized controlled trials (RCTs) involving patients which received alendronate treatment were included. Outcome measures were bone mineral density (BMD) changes, bone fractures, and adverse reactions. Data from the individual studies were pooled using random or fixed effect models based on heterogeneity. Effect size was reported as standardized mean differences (SMD) for continuous outcomes and pooled odds ratios (OR) for dichotomous outcomes, with 95% confidence interval (CI). RESULTS: Overall, 10 studies involving 1002 patients were included in the present investigation. Alendronate treatment significantly increased BMD of the lumbar spine and femoral neck during 6 to 24 months. These beneficial effects were apparent at 12 months after treatment for the lumbar spine but not the femoral neck BMD. Alendronate treatment did not significantly change fracture risk nor induce significant differences in adverse gastrointestinal effects. CONCLUSION: Alendronate significantly increases BMD of the lumbar spine and femoral neck in patients with GIO, but does not appear to reduce the risk of fractures. As relatively insufficient data regarding the GIO fracture incidence has been reported, more RCTs need to be carried out to determine the efficacy of alendronate in the prevention of GIO fracture. Wolters Kluwer Health 2018-10-19 /pmc/articles/PMC6211897/ /pubmed/30334952 http://dx.doi.org/10.1097/MD.0000000000012691 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | Research Article Wang, Ya-Kang Zhang, Yu-min Qin, Si-Qing Wang, Xu Ma, Tao Guo, Jian-Bin Zhu, Chao Luo, Zhuo-Jing Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title | Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title_full | Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title_fullStr | Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title_full_unstemmed | Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title_short | Effects of alendronate for treatment of glucocorticoid-induced osteoporosis: A meta-analysis of randomized controlled trials |
title_sort | effects of alendronate for treatment of glucocorticoid-induced osteoporosis: a meta-analysis of randomized controlled trials |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211897/ https://www.ncbi.nlm.nih.gov/pubmed/30334952 http://dx.doi.org/10.1097/MD.0000000000012691 |
work_keys_str_mv | AT wangyakang effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT zhangyumin effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT qinsiqing effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT wangxu effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT matao effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT guojianbin effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT zhuchao effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials AT luozhuojing effectsofalendronatefortreatmentofglucocorticoidinducedosteoporosisametaanalysisofrandomizedcontrolledtrials |