Tags

Type your tag names separated by a space and hit enter

Drug efficacies on bone mineral density and fracture rate for the treatment of postmenopausal osteoporosis: a network meta-analysis.
Eur Rev Med Pharmacol Sci. 2019 Mar; 23(6):2640-2668.ER

Abstract

OBJECTIVE

Globally, a great number of elderly suffer from osteoporosis, especially postmenopausal women. Osteoporosis results in low bone mineral density (BMD) and high risk of fragility fracture. However, there is no defined strategy to select the most suitable anti-osteoporotic drugs for osteoporosis patients. Therefore, this study aims to select the most effective anti-osteoporotic drug for postmenopausal women with osteoporosis.

MATERIALS AND METHODS

Literature search was conducted in PubMed, EMBASE, and the Cochrane Library. Raw data from the related randomized clinical trials were extracted. A pairwise and network meta-analysis model was utilized to assess the efficacy of ten drugs on the percentage change of BMD in the lumbar spine and total hip from baseline to one year of treatment. Risks of vertebral fracture and non-vertebral fracture were evaluated as well. We reported the effect size with a weighted mean difference (WMD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes. All the drugs were ranked based on the surface under the cumulative ranking curve (SUCRA) value. Furthermore, the heterogeneity, consistency and publication bias of enrolled literature were assessed.

RESULTS

With regard to lumbar spine BMD, the ten selected drugs all showed significant efficacy compared with placebo. In regard to total hip BMD and vertebral fracture, with the exception of calcitonin, the remaining nine drugs all showed significant efficacy compared with placebo. Six drugs - abaloparatide, alendronate, risedronate, strontium ranelate, teriparatide, and zoledronate - were significantly more effective compared with placebo for the treatment of non-vertebral fractures. As the SUCRA values indicated, abaloparatide performed the best on improving lumbar spine BMD, vertebral fracture and non-vertebral fracture, while denosumab was the best choice to improve total hip BMD.

CONCLUSIONS

To sum up, abaloparatide, denosumab, and teriparatide showed the best efficacy for the treatment of postmenopausal osteoporosis, especially abaloparatide.

Authors+Show Affiliations

Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China. prof.haiyong@yahoo.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

30964193

Citation

Yang, L, et al. "Drug Efficacies On Bone Mineral Density and Fracture Rate for the Treatment of Postmenopausal Osteoporosis: a Network Meta-analysis." European Review for Medical and Pharmacological Sciences, vol. 23, no. 6, 2019, pp. 2640-2668.
Yang L, Kang N, Yang JC, et al. Drug efficacies on bone mineral density and fracture rate for the treatment of postmenopausal osteoporosis: a network meta-analysis. Eur Rev Med Pharmacol Sci. 2019;23(6):2640-2668.
Yang, L., Kang, N., Yang, J. C., Su, Q. J., Liu, Y. Z., Guan, L., Liu, T., Meng, X. L., Wang, Y., & Hai, Y. (2019). Drug efficacies on bone mineral density and fracture rate for the treatment of postmenopausal osteoporosis: a network meta-analysis. European Review for Medical and Pharmacological Sciences, 23(6), 2640-2668. https://doi.org/10.26355/eurrev_201903_17414
Yang L, et al. Drug Efficacies On Bone Mineral Density and Fracture Rate for the Treatment of Postmenopausal Osteoporosis: a Network Meta-analysis. Eur Rev Med Pharmacol Sci. 2019;23(6):2640-2668. PubMed PMID: 30964193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Drug efficacies on bone mineral density and fracture rate for the treatment of postmenopausal osteoporosis: a network meta-analysis. AU - Yang,L, AU - Kang,N, AU - Yang,J-C, AU - Su,Q-J, AU - Liu,Y-Z, AU - Guan,L, AU - Liu,T, AU - Meng,X-L, AU - Wang,Y, AU - Hai,Y, PY - 2019/4/10/entrez PY - 2019/4/10/pubmed PY - 2020/8/26/medline SP - 2640 EP - 2668 JF - European review for medical and pharmacological sciences JO - Eur Rev Med Pharmacol Sci VL - 23 IS - 6 N2 - OBJECTIVE: Globally, a great number of elderly suffer from osteoporosis, especially postmenopausal women. Osteoporosis results in low bone mineral density (BMD) and high risk of fragility fracture. However, there is no defined strategy to select the most suitable anti-osteoporotic drugs for osteoporosis patients. Therefore, this study aims to select the most effective anti-osteoporotic drug for postmenopausal women with osteoporosis. MATERIALS AND METHODS: Literature search was conducted in PubMed, EMBASE, and the Cochrane Library. Raw data from the related randomized clinical trials were extracted. A pairwise and network meta-analysis model was utilized to assess the efficacy of ten drugs on the percentage change of BMD in the lumbar spine and total hip from baseline to one year of treatment. Risks of vertebral fracture and non-vertebral fracture were evaluated as well. We reported the effect size with a weighted mean difference (WMD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes. All the drugs were ranked based on the surface under the cumulative ranking curve (SUCRA) value. Furthermore, the heterogeneity, consistency and publication bias of enrolled literature were assessed. RESULTS: With regard to lumbar spine BMD, the ten selected drugs all showed significant efficacy compared with placebo. In regard to total hip BMD and vertebral fracture, with the exception of calcitonin, the remaining nine drugs all showed significant efficacy compared with placebo. Six drugs - abaloparatide, alendronate, risedronate, strontium ranelate, teriparatide, and zoledronate - were significantly more effective compared with placebo for the treatment of non-vertebral fractures. As the SUCRA values indicated, abaloparatide performed the best on improving lumbar spine BMD, vertebral fracture and non-vertebral fracture, while denosumab was the best choice to improve total hip BMD. CONCLUSIONS: To sum up, abaloparatide, denosumab, and teriparatide showed the best efficacy for the treatment of postmenopausal osteoporosis, especially abaloparatide. SN - 2284-0729 UR - https://www.unboundmedicine.com/medline/citation/30964193/Drug_efficacies_on_bone_mineral_density_and_fracture_rate_for_the_treatment_of_postmenopausal_osteoporosis:_a_network_meta_analysis_ L2 - https://www.europeanreview.org/article/17414 DB - PRIME DP - Unbound Medicine ER -