Alendronate for the Prevention and Treatment of Men Osteoporosis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHU Ruxia ¹ , OUYANG Lingli ¹ ,  WU Taixiang ²

1. Department of Endocrinology, the First Affiliated Hospital of Guangxi Medical University, Guangxi 530021, China 2. Evidence-based Medicine and Clinical Epidemiology Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WU Taixiang, Email: txwutx@hotmail.com

Keywords：

Alendronate; Prevention; Treatment; Men osteoporosis; Systematic review

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Objective　 To systematically review the efficacy and adverse events of alendronate on bone mineral density and fractures in men with osteoporosis.
Methods 　We electronically searched MEDLINE (1990 to 2005), EMBASE (1990 to 2005), The Cochrane Library (Issue 3, 2005), Controlled Trials Register and The National Research Register, CBM disc, VIP, and CNKI. We also handsearched some related journals. The search was conducted in Nov., 2005. The quality of included randomized controlled trials (RCTs) was evaluated and meta-analysis was conducted by RevMan 4.2.8.
Results 　We identified 7 studies including 817 patients. Sufficient evidence showed that alendronate plus calcium was superior as preventive treatment to calcium in increasing the bone mineral density (SMD 0.59, 95% CI 0.15 to 1.03, P=0.009) of the lumbar spine. The incidence of withdrawal and lost to follow-up due to adverse events of the alendronate plus calcium was lower than that of calcium (RR 0.32, 95% CI 0.11 to 0.87). Two studies showed that alendronate was superior to placebo in increasing the bone mineral density in men with osteoporosis but with no significantly statistical difference in reducing fractures. Two studies showed alendronate was superior to alfacalcidol in increasing the bone mineral density and reducing the vertebral fractures in men with osteoporosis. One study showed alendronate was not superior to calcitonin or alfacalcidol in increasing the bone mineral density in men at high risk of osteoporosis. One study comparing anledronate or parathyroid hormone with combination of these drugs in men with osteoporosis suggested that anledronate wasn’t superior to parathyroid hormone in increasing the bone mineral density, and the combination did not show any difference compared to parathyroid hormone alone.
Conclusions 　Alendronate is more effective in prevention and treatment of men with osteoporosis compared to placebo. Alendronate is more effective than alfacalcidol in increasing bone mineral density and reducingvertebral fractures in men with osteoporosis. Alendronate is not superior to alfacalcidol or calcitonin in increasing the bone mineral density in preventing men osteoporosis. Alendronate compared to combination of parathyroid hormone does not show more effectiveness in increasing the bone mineral density in men with osteoporosis. More RCTs of high quality, especially multiple center trials are needed to generate ber evidence.

Citation： ZHU Ruxia,OUYANG Lingli,WU Taixiang. Alendronate for the Prevention and Treatment of Men Osteoporosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2006, 06(3): 195-201. doi: Copy

1.	傅明捷, 黄萍, 王敏健, 等. 阿仑膦酸钠对老年男性骨质疏松症骨密度的影响. 实用老年医学, 2002; 16(1): 36-37.
2.	Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med, 1991; 90(1): 107-110.
3.	Seeman E. Advances in the study of osteoporosis in men. In Meunier PJ, ed. Osteoporosis, Diagnosis and Management. London: Martin Dunitz, 1998; 221-232.
4.	Campion JM, Maricic MJ. Osteoporosis in men. Am Fam Physician, 2003; 67(7): 1521-1526.
5.	Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001; 323(7303): 42-46.
6.	El-Agroudy AE, El-Husseini AA, El-Sayed M, et al. A prospective randomized study for prevention of postrenal transplantation bone loss. Kidney Int, 2005; 67(5):2039-2045.
7.	Finkelstein JS, Hayes A, Hunzelman JL, et al. The effects of parathyroid hormone, alendronate, or both in men with osteoporosis. N Engl J Med, 2003; 349(13): 1216-1226.
8.	Fu MJ, Huang P, Wang MJ, et al. The effect of alendronate on the bone mineral density of men with senile osteoporosis. Practical Geriatrics, 2002; 16(1): 36-37.
9.	Orwoll E, Ettinger M, Weiss S, et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med, 2000; 343(9): 604-610.
10.	Ringe JD, Faber H, Dorst A. Alendronate treatment of established primary osteoporosis in men: results of a 2-year prospective study. J Clin Endocrinol Metab, 2001; 86(11): 5252-5255.
11.	Ringe JD, Dorst A, Faber H, et al. Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study. Rheumatol Int, 2004; 24(2):110-113.
12.	Zehnder Y, Risi S, Michel D, et al. Prevention of bone loss in paraplegics over 2 years with alendronate. J Bone Miner Res, 2004; 19(7):1067-1074.

1. 傅明捷, 黄萍, 王敏健, 等. 阿仑膦酸钠对老年男性骨质疏松症骨密度的影响. 实用老年医学, 2002; 16(1): 36-37.
2. Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med, 1991; 90(1): 107-110.
3. Seeman E. Advances in the study of osteoporosis in men. In Meunier PJ, ed. Osteoporosis, Diagnosis and Management. London: Martin Dunitz, 1998; 221-232.
4. Campion JM, Maricic MJ. Osteoporosis in men. Am Fam Physician, 2003; 67(7): 1521-1526.
5. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001; 323(7303): 42-46.
6. El-Agroudy AE, El-Husseini AA, El-Sayed M, et al. A prospective randomized study for prevention of postrenal transplantation bone loss. Kidney Int, 2005; 67(5):2039-2045.
7. Finkelstein JS, Hayes A, Hunzelman JL, et al. The effects of parathyroid hormone, alendronate, or both in men with osteoporosis. N Engl J Med, 2003; 349(13): 1216-1226.
8. Fu MJ, Huang P, Wang MJ, et al. The effect of alendronate on the bone mineral density of men with senile osteoporosis. Practical Geriatrics, 2002; 16(1): 36-37.
9. Orwoll E, Ettinger M, Weiss S, et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med, 2000; 343(9): 604-610.
10. Ringe JD, Faber H, Dorst A. Alendronate treatment of established primary osteoporosis in men: results of a 2-year prospective study. J Clin Endocrinol Metab, 2001; 86(11): 5252-5255.
11. Ringe JD, Dorst A, Faber H, et al. Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study. Rheumatol Int, 2004; 24(2):110-113.
12. Zehnder Y, Risi S, Michel D, et al. Prevention of bone loss in paraplegics over 2 years with alendronate. J Bone Miner Res, 2004; 19(7):1067-1074.

Chinese Journal of Evidence-Based Medicine

Alendronate for the Prevention and Treatment of Men Osteoporosis: A Systematic Review

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