{"title":"特立帕肽和双膦酸盐对绝经后骨质疏松症妇女的骨折发生率和安全性:一项 Meta 分析。","authors":"Qi Zhong, Yuanyue Liao, Wen Zou","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the anti-fracture effect and adverse effects of teriparatide versus bisphosphonate on postmenopausal osteoporosis. This study will provide evidence-based practice for the clinical selection of more effective and safer drugs for these patients.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Library from database inception to July 2022. The keywords included \"fracture\"; \"teriparatide\", \"bisphosphonate\", \"postmenopausal women\", and \"osteoporosis\". Randomized controlled trials (RCTs) comparing teriparatide versus bisphosphonates on the risk of fracture and adverse effects in postmenopausal osteoporosis were included in the analysis.</p><p><strong>Results: </strong>Finally, 3376 participants were recruited in all 5 RCTs. The results revealed that teriparatide could decrease the rate of clinical vertebral fracture (OR=1.97, 95% CI=1.43-2.73, I2 = 0%, P < .0001) and new vertebral fractures (OR=2.44, 95% CI=1.70-3.50, I2 = 0%, P < .00001) compared with bisphosphonate. AE results refer to the type and frequency of adverse effects related to drug treatment. The rate of treatment discontinuous due to AEs (OR=0.63, 95% CI=0.48-0.83, I2 = 44%, P = .0009) with teriparatide was significantly greater than that with bisphosphonate. However, there was no significant difference in the incidence of adverse events to death (OR=0.59, 95% CI=0.30-1.18, I2 = 0%, P = .13). The proportion of patients reporting adverse events in the teriparatide versus bisphosphonate groups was consistent across subgroups, except for the rate of dizziness (OR=0.53, 95% CI=0.31-0.90, I2 = 49%, P = .02).</p><p><strong>Conclusions: </strong>Among postmenopausal women with osteoporosis, clinical vertebral fractures and new vertebral fractures decreased more in patients receiving teriparatide than in those receiving bisphosphonate. Although there were no differences in adverse events across subgroups, patients receiving teriparatide had a higher rate of dizziness than those receiving bisphosphonate.The results of this work will provide a reference for clinicians to select appropriate anti-osteoporosis drugs by comprehensively considering individual differences such as fracture risk and dizziness tolerance.</p>","PeriodicalId":7571,"journal":{"name":"Alternative therapies in health and medicine","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Fracture Incidence and Safety of Teriparatide and Bisphosphonate in Postmenopausal Women With Osteoporosis: A Meta-Analysis.\",\"authors\":\"Qi Zhong, Yuanyue Liao, Wen Zou\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the anti-fracture effect and adverse effects of teriparatide versus bisphosphonate on postmenopausal osteoporosis. This study will provide evidence-based practice for the clinical selection of more effective and safer drugs for these patients.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and the Cochrane Library from database inception to July 2022. The keywords included \\\"fracture\\\"; \\\"teriparatide\\\", \\\"bisphosphonate\\\", \\\"postmenopausal women\\\", and \\\"osteoporosis\\\". Randomized controlled trials (RCTs) comparing teriparatide versus bisphosphonates on the risk of fracture and adverse effects in postmenopausal osteoporosis were included in the analysis.</p><p><strong>Results: </strong>Finally, 3376 participants were recruited in all 5 RCTs. The results revealed that teriparatide could decrease the rate of clinical vertebral fracture (OR=1.97, 95% CI=1.43-2.73, I2 = 0%, P < .0001) and new vertebral fractures (OR=2.44, 95% CI=1.70-3.50, I2 = 0%, P < .00001) compared with bisphosphonate. AE results refer to the type and frequency of adverse effects related to drug treatment. The rate of treatment discontinuous due to AEs (OR=0.63, 95% CI=0.48-0.83, I2 = 44%, P = .0009) with teriparatide was significantly greater than that with bisphosphonate. However, there was no significant difference in the incidence of adverse events to death (OR=0.59, 95% CI=0.30-1.18, I2 = 0%, P = .13). The proportion of patients reporting adverse events in the teriparatide versus bisphosphonate groups was consistent across subgroups, except for the rate of dizziness (OR=0.53, 95% CI=0.31-0.90, I2 = 49%, P = .02).</p><p><strong>Conclusions: </strong>Among postmenopausal women with osteoporosis, clinical vertebral fractures and new vertebral fractures decreased more in patients receiving teriparatide than in those receiving bisphosphonate. Although there were no differences in adverse events across subgroups, patients receiving teriparatide had a higher rate of dizziness than those receiving bisphosphonate.The results of this work will provide a reference for clinicians to select appropriate anti-osteoporosis drugs by comprehensively considering individual differences such as fracture risk and dizziness tolerance.</p>\",\"PeriodicalId\":7571,\"journal\":{\"name\":\"Alternative therapies in health and medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alternative therapies in health and medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INTEGRATIVE & COMPLEMENTARY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alternative therapies in health and medicine","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
The Fracture Incidence and Safety of Teriparatide and Bisphosphonate in Postmenopausal Women With Osteoporosis: A Meta-Analysis.
Objective: To evaluate the anti-fracture effect and adverse effects of teriparatide versus bisphosphonate on postmenopausal osteoporosis. This study will provide evidence-based practice for the clinical selection of more effective and safer drugs for these patients.
Methods: We searched PubMed, Embase, and the Cochrane Library from database inception to July 2022. The keywords included "fracture"; "teriparatide", "bisphosphonate", "postmenopausal women", and "osteoporosis". Randomized controlled trials (RCTs) comparing teriparatide versus bisphosphonates on the risk of fracture and adverse effects in postmenopausal osteoporosis were included in the analysis.
Results: Finally, 3376 participants were recruited in all 5 RCTs. The results revealed that teriparatide could decrease the rate of clinical vertebral fracture (OR=1.97, 95% CI=1.43-2.73, I2 = 0%, P < .0001) and new vertebral fractures (OR=2.44, 95% CI=1.70-3.50, I2 = 0%, P < .00001) compared with bisphosphonate. AE results refer to the type and frequency of adverse effects related to drug treatment. The rate of treatment discontinuous due to AEs (OR=0.63, 95% CI=0.48-0.83, I2 = 44%, P = .0009) with teriparatide was significantly greater than that with bisphosphonate. However, there was no significant difference in the incidence of adverse events to death (OR=0.59, 95% CI=0.30-1.18, I2 = 0%, P = .13). The proportion of patients reporting adverse events in the teriparatide versus bisphosphonate groups was consistent across subgroups, except for the rate of dizziness (OR=0.53, 95% CI=0.31-0.90, I2 = 49%, P = .02).
Conclusions: Among postmenopausal women with osteoporosis, clinical vertebral fractures and new vertebral fractures decreased more in patients receiving teriparatide than in those receiving bisphosphonate. Although there were no differences in adverse events across subgroups, patients receiving teriparatide had a higher rate of dizziness than those receiving bisphosphonate.The results of this work will provide a reference for clinicians to select appropriate anti-osteoporosis drugs by comprehensively considering individual differences such as fracture risk and dizziness tolerance.
期刊介绍:
Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field.
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