scholarly journals Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Filippo Migliorini ◽  
Nicola Maffulli ◽  
Giorgia Colarossi ◽  
Jörg Eschweiler ◽  
Markus Tingart ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bayesian Network ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Bone Structure ◽  
Meta Analysis ◽  
Mineral Density ◽  
Level Of Evidence ◽  
Hip Bmd ◽  
Meta Analyses

Abstract Background Osteoporosis affects mostly postmenopausal women, leading to deterioration of the microarchitectural bone structure and low bone mass, with an increased fracture risk with associated disability, morbidity and mortality. This Bayesian network meta-analysis compared the effects of current anti-osteoporosis drugs on bone mineral density. Methods The present systematic review and network meta-analysis follows the PRISMA extension statement to report systematic reviews incorporating network meta-analyses of health care interventions. The literature search was performed in June 2021. All randomised clinical trials that have investigated the effects of two or more drug treatments on BMD for postmenopausal osteoporosis were accessed. The network comparisons were performed through the STATA Software/MP routine for Bayesian hierarchical random-effects model analysis. The inverse variance method with standardised mean difference (SMD) was used for analysis. Results Data from 64 RCTs involving 82,732 patients were retrieved. The mean follow-up was 29.7 ± 19.6 months. Denosumab resulted in a higher spine BMD (SMD −0.220; SE 3.379), followed by pamidronate (SMD −5.662; SE 2.635) and zoledronate (SMD −10.701; SE 2.871). Denosumab resulted in a higher hip BMD (SMD −0.256; SE 3.184), followed by alendronate (SMD −17.032; SE 3.191) and ibandronate (SMD −17.250; SE 2.264). Denosumab resulted in a higher femur BMD (SMD 0.097; SE 2.091), followed by alendronate (SMD −16.030; SE 1.702) and ibandronate (SMD −17.000; SE 1.679). Conclusion Denosumab results in higher spine BMD in selected women with postmenopausal osteoporosis. Denosumab had the highest influence on hip and femur BMD. Level of evidence Level I, Bayesian network meta-analysis of RCTs

scholarly journals Efficacy and Safety of Human Parathyroid Hormone-(1–84) in Increasing Bone Mineral Density in Postmenopausal Osteoporosis

2003 ◽  
Vol 88 (11) ◽  
pp. 5212-5220 ◽  
Author(s):  
Anthony B. Hodsman ◽  
David A. Hanley ◽  
Mark P. Ettinger ◽  
Michael A. Bolognese ◽  
John Fox ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Full Length ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Mineral Density ◽  
Double Blind ◽  
Hip Bmd

Abstract Daily sc injections of N-terminal analogs of PTH increase bone mass and decrease fractures in osteoporotic women. We investigated the efficacy and safety of human PTH-(1–84) (full-length PTH) in the treatment of postmenopausal osteoporosis in a double-blind, placebo-controlled study. The women (n = 50–53/group) self-administered PTH (50, 75, or 100 μg) or placebo by daily sc injection for 12 months. PTH treatment induced time- and dose-related increases in lumbar spine bone mineral density (BMD). The 100-μg dose increased BMD significantly at 3 months (+2.0%) and 12 months (+7.8%). BMD underestimated the anabolic effect of PTH in lumbar spine (bone mineral content, +10.0%) because bone area increased significantly (+2.0%). A nonsignificant decrease (−0.9%) in total hip BMD occurred during the first 6 months with the 100-μg dose, but this trend reversed (+1.6%) during the second 6 months. Bone turnover markers increased during the first half of the study and were maintained at elevated levels during the second 6 months. Protocol compliance was excellent (95–98%), and treatment was generally safe and well tolerated. Dose-related incidences of transient hypercalcemia occurred, but only one patient (100-μg group) was withdrawn because of repeated hypercalcemia. Thus, full-length PTH was efficacious and safe over 12 months.

scholarly journals Abdominal aortic calcification, bone mineral density and fractures: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e026232 ◽  
Author(s):  
Alexander J Rodríguez ◽  
Kevin Leow ◽  
Pawel Szulc ◽  
David Scott ◽  
Peter Ebeling ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Meta Analysis ◽  
Group Versus ◽  
Aortic Calcification ◽  
Mineral Density ◽  
Abdominal Aortic Calcification ◽  
Abdominal Aortic ◽  
Study Heterogeneity ◽  
Meta Analyses

IntroductionAbdominal aortic calcification (AAC) is associated with low bone mass and increased fracture risk. Two previous meta-analyses have investigated the association between AAC and fracture. However, these meta-analyses only identified articles until December 2016, undertook limited searches and did not explore potential sources of between-study heterogeneity. We aim to undertake a sensitive and comprehensive assessment of the relationship between AAC, bone mineral density (BMD) as well as prevalent and incident fractures.MethodsWe will search MEDLINE, EMBASE, Web of Science core collection and Google Scholar (top 200 articles sorted by relevance) from their inception to 1 June 2018. Reference lists of included studies and previous systematic reviews will be hand searched for additional eligible studies. Retrospective and prospective cohort studies (cross-sectional, case–control and longitudinal) reporting the association between AAC, BMD and fracture at any site will be included. At least two investigators will independently: (A) evaluate study eligibility and extract data, with a third investigator to adjudicate when discrepancies occur, (B) assess study quality by the Newcastle-Ottawa Scale for each cohort/study. The meta-analysis will be reported in adherence to the Meta-analysis of Observational Studies in Epidemiology criteria. AAC will be grouped as either: (1) AAC present or absent, (2) AAC categorised as ‘low’ (referent—lowest reported group) versus ‘high’ (all other groups) or (3) dose–response when AAC was assessed in ≥3 groups. Where primary event data were reported in individual studies, pooled risk differences and risk ratios with 95% CI will be calculated, from which, a summary estimate will be determined using DerSimonian-Laird random effects models. For the AAC and BMD pooled analyses, estimates will be expressed as standardised mean difference with 95% CI. We will examine the likelihood of publication bias and where possible, investigate potential reasons for between-study heterogeneity using subgroup analyses and meta-regression.Ethics and disseminationThe study will be submitted to a peer- reviewed journal and disseminated via research presentations.PROSPERO registration numberCRD42018088019.

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