1. Effectiveness of anti-osteoporotic drugs to prevent secondary fragility fractures: systematic review and meta-analysis.
- Author
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Saito, T., Sterbenz, J., Malay, S., Zhong, L., MacEachern, M., and Chung, K.
- Subjects
CALCITONIN ,EVALUATION of clinical trials ,DIPHOSPHONATES ,PARATHYROID hormone ,SELECTIVE estrogen receptor modulators ,DATABASES ,BONE fractures ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,MEDLINE ,META-analysis ,OSTEOPOROSIS ,HEALTH outcome assessment ,SPINAL injuries ,SYSTEMATIC reviews ,SAMPLE size (Statistics) ,DISEASE incidence ,THERAPEUTICS - Abstract
Patients with osteoporotic fractures have an increased risk for secondary fractures. However, a rigorous study that assesses the effectiveness of individual osteoporotic drugs in preventing subsequent fractures is lacking. The purpose of this review was to analyze the effectiveness of anti-osteoporotic drugs in preventing secondary fractures. We searched for randomized controlled trials that showed the incidence of secondary fractures while using anti-osteoporotic drugs (bisphosphonates, selective estrogen receptor modulators, parathyroid hormone (PTH), or calcitonin) in MEDLINE, , and Cochrane Central Register databases. We estimated risk ratios (RR) and numbers needed to treat (NNT) to prevent secondary fractures. Twenty-six studies met our eligibility criteria. There was a significant reduction in RR (0.38-0.77) after the use of anti-osteoporotic drugs for secondary vertebral fractures. Bisphosphonates and PTH significantly reduced the risk of a secondary non-vertebral fracture (RR 0.59 and 0.64). PTH needed the fewest number of patients to be treated to prevent a secondary vertebral fracture (NNT: 56). Our study demonstrated the effectiveness of anti-osteoporotic agents included in our systematic review in preventing secondary vertebral fractures. Bisphosphonates and PTH were most effective in preventing non-vertebral fractures. We suggest that clinicians should prescribe these drugs to prevent secondary vertebral/non-vertebral fractures. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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