Prevention of vertebral fractures in osteoporosis: Mixed treatment comparison of bisphosphonate therapies
Jansen JP et al. - Data indicate that zoledronic acid provides a greater vertebral fracture risk reduction in postmenopausal women with osteoporosis than ibandronate, alendronate, or risedronate. Methods- A comparison of the efficacy of bisphosphonates in prevention of vertebral fractures in postmenopausal women with osteoporosis
- 7 randomized placebo controlled trials investigating the effects of:
- Zoledronic acid (1 study)
- Alendronate (3 studies)
- Ibandronate (1 study), and
- Risedronate (2 studies)
- on fractures with a f/u of 3 yrs were identified
- Results of all trials were analyzed simultaneously with a Bayesian mixed treatment comparison (MTC)
Results- Zoledronic acid shows the greatest reduction in vertebral fractures of all four bisphophonates compared
- It showed an OR of 0.28 vs placebo, an OR of 0.57 vs ibandronate, an OR of 0.54 vs alendronate, and OR of 0.49 vs risedronate
- Alendronate, ibandronate, and risedronate showed comparable vertebral fracture reductions
- Indirect comparisons using a conservative random effects model supported these findings
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