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Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: A network meta-analysis

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dc.contributor.author Barrionuevo, Patricia
dc.contributor.author Kapoor, Ekta
dc.contributor.author Asi, Noor
dc.contributor.author Alahdab, Fares
dc.contributor.author Mohammed, Khaled
dc.contributor.author Benkhadra, Khalid
dc.contributor.author Almasri, Jehad
dc.contributor.author Farah, Wigdan
dc.contributor.author Sarigianni, Maria
dc.contributor.author Muthusamy, Kalpana
dc.contributor.author Al Nofal, Alaa
dc.contributor.author Haydour, Qusay
dc.contributor.author Wang, Zhen
dc.contributor.author Murad, Mohammad Hassan
dc.date.accessioned 2019-12-06T20:57:43Z
dc.date.available 2019-12-06T20:57:43Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7379
dc.description.abstract Background: Osteoporosis and osteopenia are associated with increased fracture incidence in postmenopausal women. We aimed to determine the comparative effectiveness of various available pharmacological therapies. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science, and Scopus for randomized controlled trials that enrolled postmenopausal women with primary osteoporosis and evaluated the risk of hip, vertebral, or nonvertebral fractures. A network meta-analysis was conducted using the multivariate random effects method. Results: We included 107 trials (193,987 postmenopausal women; mean age, 66 years; 55% white; median follow-up, 28 months). A significant reduction in hip fractures was observed with romosozumab, alendronate, zoledronate, risedronate, denosumab, estrogen with progesterone, and calcium in combination with vitamin D. A significant reduction in nonvertebral fractures was observed with abaloparatide, romosozumab, denosumab, teriparatide, alendronate, risedronate, zoledronate, lasofoxifene, tibolone, estrogen with progesterone, and vitamin D. A significant reduction in vertebral fractures was observed with abaloparatide, teriparatide, parathyroid hormone 1-84, romosozumab, strontium ranelate, denosumab, zoledronate, risedronate, alendronate, ibandronate, raloxifene, bazedoxifene, lasofoxifene, estrogen with progesterone, tibolone, and calcitonin. Teriparatide, abaloparatide, denosumab, and romosozumab were associated with the highest relative risk reductions, whereas ibandronate and selective estrogen receptor modulators had lower efficacy. The evidence for the treatment of fractures with vitamin D and calcium remains limited despite numerous large trials. Conclusions: This network meta-analysis provides comparative effective estimates for the various available treatments to reduce the risk of fragility fractures in postmenopausal women. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Journal of Clinical Endocrinology and Metabolism
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject abaloparatide en_US
dc.subject alendronic acid en_US
dc.subject Article en_US
dc.subject bazedoxifene en_US
dc.subject calcitonin en_US
dc.subject calcium en_US
dc.subject chemoprophylaxis en_US
dc.subject comparative effectiveness en_US
dc.subject denosumab en_US
dc.subject drug efficacy en_US
dc.subject estrogen en_US
dc.subject fragility fracture en_US
dc.subject hip fracture en_US
dc.subject human en_US
dc.subject ibandronic acid en_US
dc.subject lasofoxifene en_US
dc.subject meta analysis en_US
dc.subject parathyroid hormone en_US
dc.subject parathyroid hormone[1-34] en_US
dc.subject placebo en_US
dc.subject postmenopause osteoporosis en_US
dc.subject priority journal en_US
dc.subject progesterone en_US
dc.subject raloxifene en_US
dc.subject risedronic acid en_US
dc.subject risk reduction en_US
dc.subject romosozumab en_US
dc.subject spine fracture en_US
dc.subject strontium ranelate en_US
dc.subject systematic review en_US
dc.subject tibolone en_US
dc.subject vitamin D en_US
dc.subject zoledronic acid en_US
dc.title Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: A network meta-analysis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1210/jc.2019-00192
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.18
dc.relation.issn 1945-7197


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