The Efficacy of Bisphosphonates for Prevention of Osteoporotic Fracture: An Update Meta-analysis.
BACKGROUND
The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures.


METHODS
An approach "using systematic reviews" on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate.


RESULTS
The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62;P<0.001), vertebral fracture (OR 0.55;P<0.001) and non-vertebral fracture (OR 0.73;P<0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61;P<0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34;P=0.127).


CONCLUSIONS
This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
Ji-Hye
JH
Byun
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
Sunmee
S
Jang
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
Sumin
S
Lee
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea.
Suyeon
S
Park
Department of Internal Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
Hyun Koo
HK
Yoon
Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea.
Byung-Ho
BH
Yoon
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Yong-Chan
YC
Ha
Diphosphonates; Fractures bone; Meta-analysis as topic; Osteoporosis