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Efficacy and Safety of Bisphosphonates for Postmenopausal Women: A Systematic Review and Network Meta-analysis

Fragility fractures caused by loss of bone mass due to postmenopausal osteoporosis represent a growing morbidity worldwide. Bisphosphonates are first-line medications for fracture treatment and prevention. In the first phase, we updated a Cochrane systematic review of randomized controlled trials on alendronate, assessing its efficacy for five types of fracture prevention, quality of life, and various safety outcomes. In the second phase, we combined indirect and direct evidence to perform a network meta-analysis including alendronate and nine other bisphosphonates evaluating the comparative efficacy and safety of these treatments. Overall, 58 studies were included in the review and 83 studies in the network. Most evidence was of moderate to high quality. Alendronate and zoledronic acid were effective for preventing the most types of fractures, while off-label and unapproved bisphosphonates showed poor efficacy. More evidence is required to evaluate long-term treatment and rare adverse events.

Identiferoai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/38849
Date26 February 2019
CreatorsZheng, Carine
ContributorsWells, George
PublisherUniversité d'Ottawa / University of Ottawa
Source SetsUniversité d’Ottawa
LanguageEnglish
Detected LanguageEnglish
TypeThesis
Formatapplication/pdf

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