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Journal of Bioanalysis & Biomedicine

Journal of Bioanalysis & Biomedicine

ISSN: 1948-593X

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Osteoporotic Spine Peer Articles

Conduct a meta-analysis on the use of bisphosphonates in corticosteroid-induced osteoporosis. A Cochrane systematic review including a search in electronic databases (MEDLINE and EMBASE) and a selective manual search of reference lists and scientific summaries were carried out. A meta-analysis using random and fixed effects modeling was used on the selected trials to calculate the summary effect measures. All controlled clinical trials of the prevention or treatment of corticosteroid-induced osteoporosis with bisphosphonates of any type and reporting the results of interest were evaluated. The trials were to involve adults only and the subjects were to take an average steroid dose of 7.5 mg / day or more. The results of interest were the change in bone mineral density (BMD) in the lumbar spine and the femoral neck at 6 and 12 months. If present, data on the number of new fractures and adverse events were also extracted. The extraction was carried out by 2 independent examiners. The results are presented as a weighted average difference in the percentage change in BMD between the treatment group and the placebo group, the trials being weighted by the inverse of their variance. In the lumbar spine, the weighted mean difference between the treated group and the placebo group was 4.0% (95% CI 2.5, 5.5). At the femoral neck, the weighted mean difference was 2.1% (95% CI 0.2, 4.0). Although there was a 24% reduction in vertebral fractures, this result did not reach statistical significance. Bisphosphonates are effective in preventing and treating bone loss induced by corticosteroids in the lumbar spine. The effectiveness in preventing fractures cannot be inferred from this analysis, although changes in bone density are correlated with the risk of fracture. Bisphosphonates are less effective in preventing or treating corticosteroid-induced osteoporosis in the femoral neck.

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