Effects of teriparatide and bisphosphonate on spinal fusion procedure : A systematic review and network meta-analysis

BACKGROUND: Giving patients anti-osteoporotic agents peri-operatively is a well-accepted strategy to increase fusion rate and prevent complications. The purpose of this study was to investigate effectiveness of teriparatide and bisphosphonate on fusion surgery of thoracic and lumbar spine.

METHODS: We searched EMBASE and PubMed for randomized clinical trials (RCTs) and prospective comparative studies using teriparatide or bisphosphonate in peri-operative spinal fusion surgery. Our synthesized data of fusion rate, Oswestry disability index (ODI), and adverse event in contrast-based network meta-analysis. Pooled results were presented in risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI).

RESULTS: Our search hit eight RCTs and three prospective studies with 676 patients receiving spinal surgery. Pooled result showed that teriparatide+Denosumab leads to significantly higher fusion rate than placebo (RR, 2.84; 95% CI: 1.22 to 6.60) and bisphosphonate (RR, 2.59; 95% CI: 1.13 to 5.96). We did not observe significant finding among placebo, teriparatide, and bisphosphonate in the two network models.

CONCLUSION: This is the first network meta-analysis providing an overview of the use of teriparatide and bisphosphonate for spinal fusion surgery. Teriparatide treatments are worth to be consider for spinal fusion surgery.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

PloS one - 15(2020), 9 vom: 01., Seite e0237566

Sprache:

Englisch

Beteiligte Personen:

Cheng, Shih-Hao [VerfasserIn]
Kuo, Yi-Jie [VerfasserIn]
Chen, Chiehfeng [VerfasserIn]
Kang, Yi-No [VerfasserIn]

Links:

Volltext

Themen:

10T9CSU89I
Bone Density Conservation Agents
Calcium-Regulating Hormones and Agents
Diphosphonates
Journal Article
Meta-Analysis
Systematic Review
Teriparatide

Anmerkungen:

Date Completed 20.10.2020

Date Revised 20.10.2020

published: Electronic-eCollection

Citation Status MEDLINE

doi:

10.1371/journal.pone.0237566

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31443951X