Denosumab Versus Bisphosphonates for the Prevention of the Vertebral Fractures in Men with Osteoporosis: An Updated Network Meta-Analysis.

IF 1.2 4区医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical and Investigative Medicine Pub Date : 2022-09-21 DOI:10.25011/cim.v45i3.38875

Pengfei Li, Xiaojian Wu, Ye Li, Jianhua Huang

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引用次数: 2

Abstract

Background: The efficacy of the prevention of vertebral fractures in men with osteoporosis by treatment with denosumab is debated. This study aimed to update the comparative effectiveness of denosumab and bisphosphonates for preventing vertebral fractures in men with osteoporosis.

Methods: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials that enrolled men with osteoporosis. Fixed-effects network meta-analysis was performed to evaluate the risk of vertebral fractures, and the relative risk (RR) and 95% confident interval (CI) values were calculated.

Results: Sixteen studies were included, and the identified bisphosphonates were risedronate, alendronate, zoledronic acid, and ibandronate. Compared with placebo or control, a significant reduction in vertebral fractures was observed for denosumab (RR 0.30, 95%CI 0.13 0.68), risedronate (RR 0.39, 95%CI 0.19 0.77), and zoledronic acid (RR 0.45, 95%CI 0.21 0.98). According to the surface under the cumulative ranking curve (SUCRA), denosumab was the most effective one among the included agents for the risk reduction of vertebral fracture. However, compared with each bisphosphonate, the RR values of denosumab were not significant [RR 0.78 (95%CI 0.25 2.43) vs. risedronate, RR 0.55 (95%CI 0.18 1.75) vs. alendronate, RR 0.66 (95%CI 0.19 2.32) vs. zoledronic acid and RR 1.12 (95%CI 0.08 14.83) vs. ibandronate].

Conclusion: Denosumab effectively reduced the risk of vertebral fractures in men with osteoporosis, and this effect was comparable to that of bisphosphonates.

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Denosumab与双膦酸盐预防男性骨质疏松症椎体骨折:最新网络荟萃分析

背景:denosumab治疗预防男性骨质疏松症椎体骨折的疗效存在争议。本研究旨在更新denosumab和双膦酸盐预防男性骨质疏松症椎体骨折的比较有效性。方法:我们检索PubMed、EMBASE和Cochrane中央对照试验注册库，查找纳入骨质疏松症男性患者的随机对照试验。采用固定效应网络meta分析评估椎体骨折的风险，计算相对危险度(RR)和95%可信区间(CI)值。结果:纳入16项研究，鉴定出的双膦酸盐为利塞膦酸盐、阿仑膦酸盐、唑来膦酸盐和依班膦酸盐。与安慰剂或对照组相比，denosumab (RR 0.30, 95%CI 0.13 0.68)、rissedronate (RR 0.39, 95%CI 0.19 0.77)和唑来膦酸(RR 0.45, 95%CI 0.21 0.98)的椎体骨折发生率显著降低。从累积排序曲线下曲面(SUCRA)来看，denosumab是纳入药物中降低椎体骨折风险最有效的药物。然而，与每种双膦酸盐相比，denosumab的RR值并不显著[RR 0.78 (95%CI 0.25 2.43)与瑞塞膦酸盐，RR 0.55 (95%CI 0.18 1.75)与阿仑膦酸盐，RR 0.66 (95%CI 0.19 2.32)与唑来膦酸盐，RR 1.12 (95%CI 0.08 14.83)与伊班膦酸盐]。结论:Denosumab可有效降低男性骨质疏松症患者椎体骨折的风险，其效果与双膦酸盐相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Investigative Medicine 医学-医学：研究与实验

CiteScore

1.50

自引率

12.50%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical and Investigative Medicine (CIM), publishes original work in the field of Clinical Investigation. Original work includes clinical or laboratory investigations and clinical reports. Reviews include information for Continuing Medical Education (CME), narrative review articles, systematic reviews, and meta-analyses.