Cargando…

Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice

Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis. To date, six large randomized controlled clinical trials on the efficacy of pharmaceutical treatment in GIOP have been conducted. All of these studies have focused predominately on bone mineral density outc...

Descripción completa

Detalles Bibliográficos
Autores principales: Adami, Giovanni, Rahn, Elizabeth J, Saag, Kenneth G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755635/
https://www.ncbi.nlm.nih.gov/pubmed/31565078
http://dx.doi.org/10.1177/1759720X19876468
_version_ 1783453275853422592
author Adami, Giovanni
Rahn, Elizabeth J
Saag, Kenneth G
author_facet Adami, Giovanni
Rahn, Elizabeth J
Saag, Kenneth G
author_sort Adami, Giovanni
collection PubMed
description Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis. To date, six large randomized controlled clinical trials on the efficacy of pharmaceutical treatment in GIOP have been conducted. All of these studies have focused predominately on bone mineral density outcomes, and none of them have been statistically powered to address fracture endpoints. The purpose of this review is to highlight differences in the design and results within these large randomized GIOP clinical trials, and how these differences might affect clinical decisions. Differences between studies in trial design, populations studied, and variable efficacy impact the comparability and generalizability of these findings, and ultimately should affect practitioners’ behavior. We review the clinical trials that provide the best quality evidence on comparative efficacy and safety of GIOP treatments. We also propose suggestions on the design of future GIOP clinical trials with attention to improved generalizability, and, ideally, study designs that might achieve fracture outcomes.
format Online
Article
Text
id pubmed-6755635
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-67556352019-09-27 Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice Adami, Giovanni Rahn, Elizabeth J Saag, Kenneth G Ther Adv Musculoskelet Dis Review Glucocorticoid-induced osteoporosis (GIOP) is the most common form of secondary osteoporosis. To date, six large randomized controlled clinical trials on the efficacy of pharmaceutical treatment in GIOP have been conducted. All of these studies have focused predominately on bone mineral density outcomes, and none of them have been statistically powered to address fracture endpoints. The purpose of this review is to highlight differences in the design and results within these large randomized GIOP clinical trials, and how these differences might affect clinical decisions. Differences between studies in trial design, populations studied, and variable efficacy impact the comparability and generalizability of these findings, and ultimately should affect practitioners’ behavior. We review the clinical trials that provide the best quality evidence on comparative efficacy and safety of GIOP treatments. We also propose suggestions on the design of future GIOP clinical trials with attention to improved generalizability, and, ideally, study designs that might achieve fracture outcomes. SAGE Publications 2019-09-20 /pmc/articles/PMC6755635/ /pubmed/31565078 http://dx.doi.org/10.1177/1759720X19876468 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Adami, Giovanni
Rahn, Elizabeth J
Saag, Kenneth G
Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title_full Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title_fullStr Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title_full_unstemmed Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title_short Glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
title_sort glucocorticoid-induced osteoporosis: from clinical trials to clinical practice
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755635/
https://www.ncbi.nlm.nih.gov/pubmed/31565078
http://dx.doi.org/10.1177/1759720X19876468
work_keys_str_mv AT adamigiovanni glucocorticoidinducedosteoporosisfromclinicaltrialstoclinicalpractice
AT rahnelizabethj glucocorticoidinducedosteoporosisfromclinicaltrialstoclinicalpractice
AT saagkennethg glucocorticoidinducedosteoporosisfromclinicaltrialstoclinicalpractice