Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis
Abstract Background The standard treatment for osteoporosis was controversial. Denosumab and bisphosphonates were two most common drugs. The purpose of this study was to compare the efficacy and safety of denosumab with bisphosphonates to treat osteoporosis. Methods Published literatures, only inclu...
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doaj-2f7597ce9acc4125888c51c0c0866fb92020-11-24T21:34:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-08-011311910.1186/s13018-018-0865-3Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysisJiaqi Wu0Qingsheng Zhang1Guanghui Yan2Xianhui Jin3The Second Department of Orthepaedics, Harrison International Peace HospitalThe Second Department of Orthepaedics, Harrison International Peace HospitalThe Second Department of Orthepaedics, Harrison International Peace HospitalThe Second Department of Orthepaedics, Harrison International Peace HospitalAbstract Background The standard treatment for osteoporosis was controversial. Denosumab and bisphosphonates were two most common drugs. The purpose of this study was to compare the efficacy and safety of denosumab with bisphosphonates to treat osteoporosis. Methods Published literatures, only including randomized controlled trials (RCTs), were searched in the following electronic databases: PubMed, Embase, Web of Science, Cochrane Library, and Google database from inception to April 20 2018. Studies that compared denosumab with bisphosphonates to treat osteoporosis were included. Random-effect model was used for meta-analysis due to the unavoidable clinical heterogeneity. We used the risk of fracture as the primary outcome. Stata 12.0 was used for meta-analysis. Results Eleven studies involving 5446 patients (denosumab = 2873, bisphosphonates = 2573) were included in the present meta-analysis. There was no significant difference between the risk of fracture (risk ratio (RR), 1.13; 95% confidence interval (CI), 0.82–1.55; P = 0.466), adverse events (AEs) (RR 1.00; 95% CI 0.96–1.04; P = 0.957) and withdrawn due to AEs (RR 0.68; 95% CI 0.34–137; P = 0.280). Denosumab compared with bisphosphonates significantly increased change in total hip, femoral neck, lumbar spine, and one-third radius bone mineral density (BMD) for postmenopausal osteoporosis patients (P < 0.05). Conclusions Our meta-analysis suggested that denosumab but not bisphosphonates significantly increased change in total hip, femoral neck, lumbar spine, and one-third radius BMD for postmenopausal osteoporosis patients. Current evidence suggested no benefit of denosumab for reducing risk of fracture than bisphosphonates. More long-term follow-up RCTs are needed to identify the potential complications of denosumab.http://link.springer.com/article/10.1186/s13018-018-0865-3DenosumabBisphosphonatesFractureMeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiaqi Wu Qingsheng Zhang Guanghui Yan Xianhui Jin |
spellingShingle |
Jiaqi Wu Qingsheng Zhang Guanghui Yan Xianhui Jin Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis Journal of Orthopaedic Surgery and Research Denosumab Bisphosphonates Fracture Meta-analysis |
author_facet |
Jiaqi Wu Qingsheng Zhang Guanghui Yan Xianhui Jin |
author_sort |
Jiaqi Wu |
title |
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
title_short |
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
title_full |
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
title_fullStr |
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
title_full_unstemmed |
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
title_sort |
denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2018-08-01 |
description |
Abstract Background The standard treatment for osteoporosis was controversial. Denosumab and bisphosphonates were two most common drugs. The purpose of this study was to compare the efficacy and safety of denosumab with bisphosphonates to treat osteoporosis. Methods Published literatures, only including randomized controlled trials (RCTs), were searched in the following electronic databases: PubMed, Embase, Web of Science, Cochrane Library, and Google database from inception to April 20 2018. Studies that compared denosumab with bisphosphonates to treat osteoporosis were included. Random-effect model was used for meta-analysis due to the unavoidable clinical heterogeneity. We used the risk of fracture as the primary outcome. Stata 12.0 was used for meta-analysis. Results Eleven studies involving 5446 patients (denosumab = 2873, bisphosphonates = 2573) were included in the present meta-analysis. There was no significant difference between the risk of fracture (risk ratio (RR), 1.13; 95% confidence interval (CI), 0.82–1.55; P = 0.466), adverse events (AEs) (RR 1.00; 95% CI 0.96–1.04; P = 0.957) and withdrawn due to AEs (RR 0.68; 95% CI 0.34–137; P = 0.280). Denosumab compared with bisphosphonates significantly increased change in total hip, femoral neck, lumbar spine, and one-third radius bone mineral density (BMD) for postmenopausal osteoporosis patients (P < 0.05). Conclusions Our meta-analysis suggested that denosumab but not bisphosphonates significantly increased change in total hip, femoral neck, lumbar spine, and one-third radius BMD for postmenopausal osteoporosis patients. Current evidence suggested no benefit of denosumab for reducing risk of fracture than bisphosphonates. More long-term follow-up RCTs are needed to identify the potential complications of denosumab. |
topic |
Denosumab Bisphosphonates Fracture Meta-analysis |
url |
http://link.springer.com/article/10.1186/s13018-018-0865-3 |
work_keys_str_mv |
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