title: Effects of combined alendronate and alfacalcidol on prevention of fractures in osteoporosis patients: a network meta-analysis.
abstract: BACKGROUND
  Published literatures report controversial results about the effect of combined treatment with alendronate and alfacalcidol for the prevention of fractures in osteoporosis patients.
  
  
  METHODS
  Seven common databases were searched for related randomized controlled trials published up to April, 2015. Bayesian random effects network meta-analysis was used to assess the pairwise odds ratios (OR), 95% credible intervals (CI).
  
  
  RESULTS
  Thirteen randomized controlled trials were identified (3710 patients). The network meta-analysis results indicated that combining treatment with alendronate and alfacalcidol was significantly better to prevent bone fractures in osteoporosis patients than alendronate (OR=0.53, 95% CI: 0.19-0.95) and alfacalcidol (OR=0.25, 95% CI: 0.08-0.49). In addition, there was no significant difference for adverse events among the three therapeutic regimen.
  
  
  CONCLUSIONS
  Combined treatment with alendronate and alfacalcidol was more active than the monotherapies in preventing bone fractures in osteoporosis patients. Large-scale randomized, controlled trials are recommended to confirm the result.
authors.affiliation: Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University Shijiazhuang 050031, Hebei, China.
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Shao
authors.affiliation: Department of Orthopedic, Cardiovascular Diseases Hospital Shijiazhuang 050037, Hebei, China.
authors.forename: Yue-Ming
authors.initials: YM
authors.lastname: Yao
authors.affiliation: Department of Otolaryngology, Second Hospital of Hebei Medical University Shijiazhuang 050000, Hebei, China.
authors.forename: Zhao-Yan
authors.initials: ZY
authors.lastname: Wang
authors.affiliation: Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University Shijiazhuang 050031, Hebei, China.
authors.forename: Qing-Fu
authors.initials: QF
authors.lastname: Zhang
authors.affiliation: Department of Burn and Plastic Surgery, First Hospital of Hebei Medical University Shijiazhuang 050031, Hebei, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
keywords: Osteoporosis; alendronate; alfacalcidol; drug therapy; fractures; network meta-analysis