title: [A Meta-analysis of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis].
abstract: OBJECTIVE
  To assess the efficiency and safety of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP).
  
  
  METHODS
  The electronic databases of PubMed, EMBASE, Cochrane Library, Web of Science, Chinese BioMedical Literature Database (CBM) and Wanfang Data were searched for all randomized controlled trials (RCT) of alendronate vs. placebo. Two reviewers independently selected trials for inclusion, assessed trial quality using Jadad's scale and extracted the data. RevMan 5.1 software was used for data synthesis and Meta-analysis.
  
  
  RESULTS
  Seven studies with 1111 patients were included. Compared with placebo, alendronate significantly increased bone mineral density (BMD) at the lumbar spine[MD = 3.35, 95%CI (2.67-4.02), P = 0.000] and the femoral neck[MD = 1.90, 95%CI (0.89-2.92), P = 0.000] after 12 months of therapy. After 24 months of therapy, alendronate significantly increased BMD at the lumbar spine[MD = 3.91, 95%CI (2.37-5.45), P = 0.000], but not at the femoral neck[MD = 1.91, 95%CI (-1.15-5.02), P = 0.22]. Compared with placebo, no significant reduction was found by the use of alendronate in the incidence of vertebral fractures [RR = 1.00, 95%CI (0.49-2.07), P = 0.99] or nonvertebral fractures [RR = 1.02, 95%CI (0.49-2.14), P = 0.95]. No difference was shown with the adverse event between the two groups[RR = 0.97, 95%CI (0.90-1.05), P = 0.47].
  
  
  CONCLUSIONS
  Alendronate is effective for the prevention and treatment of glucocorticoid-induced bone loss at the lumbar spine and the femoral neck with relatively good safety profile. Yet, there is no significant difference between the two groups in reducing the incidence of vertebral fractures and non-vertebral fractures. Large-scale RCT designed to observe whether different lengths of alendronate therapy will influence the efficiency should be conducted in the future and to further explore whether it can reduce the incidence of fractures.
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Jin-hui
authors.initials: JH
authors.lastname: Tian
authors.forename: Zhi-yu
authors.initials: ZY
authors.lastname: He
authors.affiliation: Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou 730000, China. Email: xulei_tang@126.com.
authors.forename: Xu-lei
authors.initials: XL
authors.lastname: Tang
authors.forename: Ke-hu
authors.initials: KH
authors.lastname: Yang
mesh_terms: D019386:Alendronate / Q000494:pharmacology / Q000627:therapeutic use*; D015519:Bone Density; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D005938:Glucocorticoids; D019386:Alendronate