Evaluation of comparative effectiveness and safety of bisphosphonates
10.13699/j.cnki.1001-6821.2015.12.035
- VernacularTitle:双膦酸盐类抗骨质疏松治疗的相对有效性及安全性评估
- Author:
Jun-Wen ZHOU
1
;
Xiang MA
;
Suo-Di ZHAI
Author Information
1. 北京大学第三医院药剂科
- Keywords:
osteoporosis;
bisphosphonate;
network Meta-analysis;
fracture;
gastrointestinal adverse event
- From:
The Chinese Journal of Clinical Pharmacology
2015;(12):1197-1201
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the comparative effectiveness and safety of bisphosphonates.Methods PubMed and Cochrane Database of Systematic Review were electronically searched for Meta -analysis and network Meta-analysis about the effectiveness and safety of bisphospho-nates.The randomized controlled trials ( RCTs ) comparing different bi-sphosphonates were manually searched.We then complete the descriptive analysis about the direct and indirect comparison between bisphospho-nates.Results Seventeen Meta-analyses were included, including 1 Meta-analysis comparing different bisphosphonates, 10 Meta-analyses comparing bisphosphonates and placebo, and 6 network Meta-analyses. The results of direct comparison showed that there was no significant difference between different bisphosphonates in effectiveness and safety. The results of indirect comparison showed that zoledronic acid, alendr-onate or zoledronic acid, alendronate, risedronate ranked first in preven-ting vertebral fracture, hip fracture, wrist, non -hip -non -vertebral fracture among different bisphosphonates, respectively.Zoledronic acid, zoledronic acid, etidronate ranked highest in causing any gastrointestinal adverse events, nausea, and discontinuation due to adverse drug reactions among different bisphosphonates, respective-ly.Conclusion Bisphosphonates are effective and safe medications for treating osteoporosis.Although zoledronic acid ranked highest in preventing fracture, it was also more likely to cause gastrointestinal adverse events.However, the quality of a body of evidence comparing different bisphosphonates is low.More well -designed clinical studies are needed to support above conclusion.
