An overview of systematic reviews of bisphosphonates in the treatment of postmenopausal osteoporosis
10.13699/j.cnki.1001-6821.2016.06.025
- VernacularTitle:双膦酸盐治疗绝经后骨质疏松的系统评价再评价
- Author:
Chu-Jun LUO
1
;
Min-Juan LI
;
Dai-Yun ZHONG
;
Jian-Ping ZHANG
Author Information
1. 暨南大学药学院
- Keywords:
bisphosphonates;
postmenopausal osteoporosis;
indirect comparison;
overviews of review;
Meta-analysis
- From:
The Chinese Journal of Clinical Pharmacology
2016;32(6):557-559
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of bisphosphonate thera-pies regarding the treatment of vertebraland non vertebral-non hip frac-tures in postmenopausal women with osteoporosis.Methods We searched systematic reviews on the databases in Cochrane Library , PubMed, SCI, CNKI, VIP, CBM and Wangfang database, as well as hand searching.The reviews were identified with a systematic literature search.Then the data were extracted by standardized forms, and the methodological qualities of the reviews were assessed by the AMSTAR tool.The endpoints of interest were vertebral and non -vertebral frac-tures.The Meta-analysis was evaluated by RevMan 5.3 software.Re-sults of all reviews were analyzed byindirect comparison.Results A to-tal of 12 systematic reviews were included.There were six bisphopho-nates in these reviews ( including alendronate, ibandrinate, etidronate, risedronate, pamidronate, and zoledronic acid).All the reviews were in high quality.The results of Meta-analysis showed that there was statisti-cally significant by five bisphosphonates, expect for pamidronate.So there were five bisphosphonates ( alendronate, ibandrinate, etidronate, risedronate, and zoledronic acid ) analyzed with indirect comparion.In vertebral fractures of all bisphophonates compared, zoledronic acidshowed a relative risk ( RR ) of 0.49 relative to placebo, and RRs were 0.49, 0.53, 0.51, 0.74 relative to risedronate, ibandronate, alendronate, etidronate.Regarding non-vertebral fractures, RRs of zoledronic acid relative to placebo, risedronate, alendronate, ibandronate, etidronate were 0.72, 0.71, 0.87, 0.89, and 0.90, respectively.Risedronate showed the greatest reduction in any fractures, followed by zoledronic acid.Conclusion In summary, zoledronic acid has the best effectiveness on the treatment of osteoporosis among the five bisphosphonate.