A Cochrane review [Abstract] 1 included 27 studies with a total of 3 075 subjects. The aim of the review was to assess the benefits and harms of bisphosphonates for the prevention and treatment of glucocorticoid-induced osteoporosis in adults. Bisphosphonates reduced the risk of vertebral fractures, but made little or no difference in preventing nonvertebral fractures (table T1). They prevented and treated corticosteroid-induced bone loss at both the lumbar spine and femoral neck. There was no statistically significant differences in the occurrence of serious adverse events or withdrawals due to adverse events.
Outcome | Relative efffect (95% CI) | Assumed risk - control | Corresponding risk - bisphosphonates (95% CI) | NNTB (95% CI) | Participants (studies) |
---|---|---|---|---|---|
Incident vertebral fractures (radiographic follow-up 12-24 months) | RR 0.57 (0.35 to 0.91) | 77 per 1000 | 44 per 1000(27 to 70) | 31 (20 to 145) | 1 343(12 studies) |
Incident nonvertebral fractures(radiographic follow-up 12-24 months) | RR 0.79 (0.47 to 1.33) | 55 per 1000 | 42 per 1000(25 to 69) | - | 1 245(9 studies) |
Lumbar spine BMD(DEXA follow-up 12 months) | - | Mean per cent change in BMD was -3.19% (-8.08% to 1.70%) | Mean per cent change in BMD was 3.50% higher than control groups (2.90% to 4.10% higher) | 3 (2 to 3) | 2 042(23 studies) |
Femoral neck BMD(DEXA follow-up 12 months) | - | Mean per cent change in BMD was -1.59% (-10.49% to 7.31%) | Mean per cent change in BMD was 2.06% higher than control groups (1.45% to 2.68% higher) | 5 (4 to 7) | 1 665(18 studies) |
Serious adverse events(follow-up 12-24 months) | RR 0.91 (0.74 to 1.12) | 162 per 1000 | 147 per 1000(120 to 181) | - | 1 703(15 studies) |
Withdrawals due to adverse events (follow-up 12-24 months) | RR 1.06 (0.77 to 1.47) | 73 per 1000 | 77 per 1000(56 to 107) | - | 1 790(15 studies) |
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