The efficacy and safety of bisphosphonate analogs for treatment of osteoporosis after spinal cord injury : a systematic review and meta-analysis of randomized controlled trials

Bisphosphonates can inhibit osteoclast-mediated bone resorption, prevent bone loss, and reduce the risk of osteoporotic fractures. Our meta-analysis of studies shows that early bisphosphonate administration after SCI was safe and beneficial to the BMD of the total hip and lumbar spine at 12 months.

INTRODUCTION: Rapid bone loss in the early stages of spinal cord injury (SCI) leads to an increased risk of osteoporotic fracture. A meta-analysis was conducted to assess the efficacy and safety of bisphosphonates for the treatment of osteoporosis after SCI.

METHODS: A literature search of the PubMed, EMBASE, Cochrane Library, and Web of Science databases identified nine randomized controlled trials with 206 individuals. This meta-analysis was performed using a random-effects model. The primary outcome was the percent change in bone mineral density (BMD) of the total hip, distal femur, and lumbar spine from baseline to 12 months. Bone turnover markers were secondary outcomes. The incidences of adverse events were assessed in order to evaluate safety.

RESULTS: There were significant differences in BMD of the total hip and lumbar spine or serum C-terminal telopeptide between the bisphosphonate and control groups but no difference in adverse events. The percent change in BMD of the distal femur and serum type 1 procollagen N-terminal peptide from baseline to 12 months was not superior in the treatment groups. Osteoclast-mediated bone resorption was inhibited by bisphosphonate administration. Subgroup analyses of participants treated with zoledronate at different sites revealed a beneficial effect on BMD of the total hip and lumbar spine but not the distal femur.

CONCLUSION: Early bisphosphonate administration after SCI was safe and beneficial to the BMD of the total hip and lumbar spine at 12 months.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA - 32(2021), 6 vom: 31. Juni, Seite 1117-1127

Sprache:

Englisch

Beteiligte Personen:

Wu, Y [VerfasserIn]
Wang, F [VerfasserIn]
Zhang, Z [VerfasserIn]

Links:

Volltext

Themen:

Bisphosphonates
Bone Density Conservation Agents
Bone loss
Bone mineral density
Diphosphonates
Efficacy
Journal Article
Meta-Analysis
Osteoporosis
Spinal cord injury
Systematic Review

Anmerkungen:

Date Completed 19.05.2021

Date Revised 28.06.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s00198-020-05807-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM319508978