A meta-analysis shows teriparatide as an effective pharmacological agent in prevention of osteoporotic fractures

Primary tabs

A meta-analysis shows teriparatide as an effective pharmacological agent in prevention of osteoporotic fractures

Osteoporosis is characterized by systemic impairment of bone mass and strength which may further increase the risk of fragile fractures. Several pharmacological agents like bisphosphonates (i.e. alendronate; ALE, risedronate; RIS, clodronate;COL, human parathyroid hormone; PTH, selective estrogen (EST) receptor modulators (raloxifene (RAL)) are used these days to prevent osteoporotic fractures.

A network meta-analysis (NMA) was done by researchers from Xiangya Hospital of Central South University, Changsha, China, to assess the most effective and safe osteoporosis drug among the available pharmacological treatments for osteoporosis. This analysis used various direct and indirect available data to compare the efficacy of drugs. Finally, teriparatide was found to be most effective in preventing new non-vertebral fractures.

For this analysis, various medical databases including China National Knowledge Internet (CNKI), PubMed and Embase for relevant literatures were searched. This search initially included 1,444 publications from which 35 articles (1990 to 2014) were selected based on the inclusion criteria which included -1) sufficient data for NMA. 2) >30 subjects. 3) Randomized controlled trials diagnosed with post-menopausal osteoporosis. 4) At least one pairwise comparison between these interventions (ALE, COL, DEN, ETI, RAL, RIS, STR, TER, ZOL, EST+PRO, PCB). 5) At least one of (new non-vertebral fractures, hip fractures, wrist fractures, adverse events) endpoints assessed by the study.

It included comparison of 11 agents of bisphosphonates (ALE, COL, ETI, RIS and ZOL), PTH (TER), biologics (DEN), selective EST receptor modulators (RAL, EST+PRO) and strontium ranelate (STR) versus PCB.The analysis depicted that alendronate and denosumab showed better results in patients at lower risk to develop new, non-vertebral fractures as compared to placebo treated patients. Alendronate, denosumab and zoledronc acid was found to be effective in the prevention of hip fractures. No specific differences were reported, other than in the prevention of wrist fractures. Zoledronic acid showed the considerably increased risk of adverse events than alendronate, denosumab, raloxifene, and placebo.

According to the surface under the cumulative ranking curve (SUCRA), teriparatide was more effective among all, in the prevention of new, non-vertebral fractures. Etidronate and denosumab were high in balanced safety and efficacy profile.



Link to the source:


The original title of the article:

Network Meta-Analysis of Pharmacological Agents for Osteoporosis Treatment and Fracture Prevention


Yang XC et al.

Therapeutic, Teriparatide, Etidronate, Denosumab, Osteoporosis, Bones, Recombinant human parathyroid hormone, Bisphosphonates, Anti-RANKL agents, Network Meta-Analysis (NMA), Safety, Efficacy
Log in or register to post comments