Meta-analysis about efficacy of anti-resorptive drugs in post-menopausal osteoporosis.
OBJECTIVE
The purpose of this study was to compare the effect of three groups of anti-resorptive drugs in post-menopausal osteoporosis.


METHODS
We collected data covering the period between 1983 and 1995, by first using MEDLINE. References retrieved were scanned further to identify additional papers.


METHODS
Only randomized studies evaluating bone mass by means of dual-photon or dual energy densitometry over a period of 1 year were accepted.


METHODS
Studies were arranged into three drug groups. We used densitometry results after 1 year in all treatment or control groups. Factors which might interfere with the results were recorded for subsequent separate analysis.


RESULTS
The MEDLINE search identified almost 25,000 studies. On reading the abstracts, 275 trials appeared to be controlled trials and original copies were retrieved for detailed analysis. A total of 31 articles which satisfied the inclusion criteria were identified. The first meta-analysis included studies which compared oestrogens and placebo, and the global effect-size was 0.54 (95% CI 0.34, 0.73). The second meta-analysis compared calcitonins with placebo and produced an effect-size of 0.41 (95% CI 0.21, 0.61) The third analysis compared bisphosphonates and placebo and showed an effect-size of 0.87 (95% CI 0.68, 1.07). Only oestrogen dose affected the results found.


CONCLUSIONS
Bisphosphonates had the greatest effect on bone mass in post-menopausal osteoporosis.
Macedo
J M
JM
Universidade Federal da Bahia, Faculdade de Medicina, Departamento de Medicina, Salvador, Brazil.
Macedo
C R
CR
Elkis
H
H
De Oliveira
I R
IR
D001862:Bone Resorption / Q000188:drug therapy / Q000517:prevention & control*; D002116:Calcitonin / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy* / Q000517:prevention & control; D010919:Placebos; D017698:Postmenopause / Q000378:metabolism*; D016032:Randomized Controlled Trials as Topic
D004164:Diphosphonates; D004967:Estrogens; D010919:Placebos; D002116:Calcitonin