title: Hip and non-spine fracture risk reductions differ among antiresorptive agents: Evidence from randomised controlled trials.
abstract: A number of antiresorptive agents reduce the risk of vertebral fractures, but few have shown consistent effects on hip and other non-spine fractures. Meta-analysis provides a more precise estimate than individual trials when results are consistent across pooled trials. Earlier meta-analyses summarised the results for vertebral and non-spine fractures. New data have emerged for hormone therapy (HT), alendronate (ALN), risedronate (RIS) and ibandronate (IBN). We surveyed recent reports of randomised, placebo-controlled trials with non-spine and/or hip fracture data, and used meta-analysis where appropriate to test for heterogeneity and derive pooled estimates. The magnitude of effect on hip fracture appears to be similar to that for non-spine fracture for each drug, but differs among drugs. Based on the current data, ALN reduces the risk of hip and non-spine fracture by 49-55%, HT by 25-36% and RIS by 26-27%. There is insufficient and/or inconsistent evidence of an effect on these fractures for IBN, calcitonin and raloxifene.
authors.affiliation: Felsenstein Medical Research Center, Department of Physiology & Pharmacology, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. uliberm@post.tau.ac.il
authors.forename: U A
authors.initials: UA
authors.lastname: Liberman
authors.forename: M C
authors.initials: MC
authors.lastname: Hochberg
authors.forename: P
authors.initials: P
authors.lastname: Geusens
authors.forename: A
authors.initials: A
authors.lastname: Shah
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: A
authors.initials: A
authors.lastname: Chattopadhyay
authors.forename: P D
authors.initials: PD
authors.lastname: Ross
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents