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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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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 |
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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 |
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