• 1. Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China;
  • 2. Department of Pharmacy, Peking University First Hospital-Miyun Hospital, Beijing 101500, China;
  • 3. School of basic medicine and clinical pharmacy, China Pharmaceutical University, Nanjing 211198, China;
ZHANGChao, Email: laural.zhang@yahoo.com
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Objective To evaluate the efficacy and safety of bisphosphonates in preventing and treating glucocorticoid induced osteoporosis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) related bisphosphonates for the prevention and treatment of glucocorticoid induced osteoporosis from inception to January 2016. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of included studies. Meta-analysis was performed using RevMan 5.3 software. Results A total of 20 RCTs were included, which involved 2 330 patients. The results of meta-analysis showed that, compared with the placebo group, the bisphosphonates group could significantly increase the bone mineral density (BMD) at lumbar and femoral neck (MD=3.70, 95%CI 2.65 to 4.75, P<0.000 01; MD=2.18, 95%CI 1.30 to 3.06, P<0.000 01), but the bisphosphonates group could not decrease the incidence rates of vertebral fracture or non-vertebral fracture (OR=0.66, 95%CI 0.38 to 1.16, P=0.15; OR=0.73, 95%CI 0.42 to 1.28, P=0.28). There were no significant differences in the incidence rates of total adverse reactions and total severe adverse reactions between the two groups (OR=0.89, 95%CI 0.62 to 1.28, P=0.53; OR=0.93, 95%CI 0.62 to 1.39, P=0.72). Conclusion Current evidence shows that, compared with placebo, bisphosphonates canld effectively prevent and treat the decrease of bone mineral density of glucocorticoid induced osteoporosis, not decrease the incidence of fracture, but not increase the incidence of adverse reactions.

Citation: ZHAOHong-wei, ZHANGChao, QIUTing-ting. Efficacy and Safety of Bisphosphonates for Glucocorticoid Induced Osteoporosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2016, 16(12): 1423-1433. doi: 10.7507/1672-2531.20160215 Copy

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