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Effectiveness of anti-osteoporotic drugs to prevent secondary fragility fractures: systematic review and meta-analysis.
- Source :
-
Osteoporosis International . Dec2017, Vol. 28 Issue 12, p3289-3300. 12p. 9 Charts. - Publication Year :
- 2017
-
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]
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 0937941X
- Volume :
- 28
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Osteoporosis International
- Publication Type :
- Academic Journal
- Accession number :
- 126198240
- Full Text :
- https://doi.org/10.1007/s00198-017-4175-0