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Prevention of vertebral fractures in osteoporosis: Mixed treatment comparison of bisphosphonate therapies
Current Medical Research and Opinion, 06/25/09

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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