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Prevention of vertebral fractures in osteoporosis: Mixed treatment comparison of bisphosphonate therapies
Current Medical Research and Opinion, 06/23/09

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.

• 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)

• 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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