The efficiency and safety of alendronate versus teriparatide for treatment glucocorticoid-induced osteoporosis: A meta-analysis and systematic review of randomized controlled trials.

Abstract

BACKGROUND:

Glucocorticoid-induced osteoporosis (GIOP) is the most common secondary osteoporosis, alendronate (ALE) and teriparatide (TPTD) are widely used in the treatment of GIOP. However, which of these two drugs has a better curative effect needs the support of evidence-based medicine.

METHODS:

We searched PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar for randomized controlled trials of ALE and TPTD in the treatment of glucocorticoid-induced osteoporosis until February 2022. These patients included in the study took glucocorticoid doses greater than 7.5 mg/d for more than 3 months before treatment with ALE and TPTD. The risk ratio (RR) and its 95% confidence interval (CI) are used as the influence index of discontinuous data, and the standardized mean difference (SMD) and its 95% CI are used as the influence index of continuous data.

RESULTS:

A total of 4102 patients were enrolled in all 5 studies that met the admission criteria. We found that compared with ALE, TPTD could reduce the rate of new vertebral fracture (RR = 0.13, 95% CI: 0.05-0.34, P<0.00001). TPTD increased LS bone mineral density (BMD) (0.53, 95% CI 0.42-0.64, P<0.00001), TH BMD (0.17, 95% CI 0.05-0.28, P = 0.004) and FN BMD (0.17, 95% CI 0.05-0.29, P = 0.006) compared to ALE. However, there was no significant difference in the incidence of non-vertebral fracture and adverse events between the two groups.

CONCLUSIONS:

Compared with ALE, TPTD is an effective drug to reduce vertebral fracture risk in patients with GIOP. Furthermore, long-term use of TPTD can increase the bone mineral density of LS, FN, and TH.

• Authors: Zhi-Ming Liu, Min Zhang, Yuan Zong, Ding Zhang, Zhu-Bin Shen, Xiao-Qing Guan, Fei Yin
• Journal: PloS one (PLoS One) Vol. 17 Issue 5 Pg. e0267706 ( 2022) ISSN: 1932-6203 [Electronic] United States
• PMID: 35639783 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Bone Density Conservation Agents
• Glucocorticoids
• Teriparatide
• Alendronate

Topics

• Alendronate (adverse effects)
• Bone Density Conservation Agents (adverse effects)
• Glucocorticoids (adverse effects)
• Humans
• Osteoporosis (chemically induced, drug therapy)
• Randomized Controlled Trials as Topic
• Spinal Fractures
• Teriparatide (adverse effects)