title: Effect of clodronate treatment on risk of fracture: a systematic review and meta-analysis.
abstract: A systematic review and a meta-analysis of data of literature were performed to evaluate the efficacy of clodronate in the reduction of risk of fractures in patients with osteoporosis or tumour diseases. A systematic review was conducted to identify original articles, reviews, and any other literature report suitable for the purposes of the meta-analysis, limited to prospective randomized trials that included a placebo or an untreated control arm. The search has identified 18 trials, 13 of which in patients with cancer diseases (breast cancer and multiple myeloma were prevalent), 4 in patients with osteoporosis/low BMD, and 1 in elderly women living in community. A placebo control arm was used in 13 trials. Treatment and follow-up duration ranged from 3 months to 5 years. The meta-analysis showed that treatment with clodronate was associated with a reduction of the probability of new fractures compared with controls (OR = 0.572, 95% CI 0.465-0.704 for new vertebral fractures; OR = 0.668, 95% CI 0.494-0.905 for new non-vertebral fractures; and OR = 0.744, 95% CI 0.635-0.873 for new overall fractures in those articles where vertebral and non-vertebral new fractures were not considered separately). Similar findings were observed in the separate analysis in patients with cancer forms or osteoporosis. The results of the meta-analysis have demonstrated that clodronate is effective in reducing the risk of vertebral, non-vertebral, and overall fractures in patients with skeletal fragility.
authors.affiliation: Rheumatology Department, Osteoporosis and Osteoarticular Instrumental Diagnosis Centre, University of Siena, Siena, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Frediani
authors.forename: E
authors.initials: E
authors.lastname: Baraldi
authors.forename: G
authors.initials: G
authors.lastname: Cremonesi
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D004002:Clodronic Acid / Q000008:administration & dosage*; D005260:Female; D017102:Fracture Healing / Q000187:drug effects*; D050723:Fractures, Bone / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy / Q000517:prevention & control*; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D011336:Probability; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
chemical_list: D050071:Bone Density Conservation Agents; D004002:Clodronic Acid