Abstract
Objectives
Although a few trials have explored whether bisphosphonates (BPs) prevented recurrent
fragility fractures (FFs), little is known about the secondary preventative effects
of BPs. Thus, we performed a meta-analysis to examine the effects of BPs on prevention
of subsequent fractures, mortality, and on bone metabolic and functional parameters
related to FF. We compared BP and control groups.
Design
A meta-analysis of randomized controlled trials was conducted.
Setting and Participants
Twelve randomized controlled trials that included 5670 participants investigating
the effects of BPs following FF were retrieved from PubMed, Embase, and the Cochrane
Library.
Measures
We performed a pairwise meta-analysis using fixed- and random-effects models.
Results
BPs exhibited significant secondary preventative effects after FF compared with controls
[overall standardized mean difference = 0.766; 95% confidence interval (CI) 0.493–1.038;
P < .001]. The risks of subsequent fracture (odds ratio = 0.499; 95% CI 0.418–0.596;
P < .001) and mortality (odds ratio = 0.662; 95% CI 0.511–0.858; P = .002) decreased in the BP groups. Bone mineral density, bone turnover marker levels,
pain at the fracture site, and health-related quality of life also differed significantly
between the groups.
Conclusions/Implications
Our meta-analysis revealed that BPs administered after FF potentially prevented subsequent
fractures and reduced mortality. Positive effects in terms of pain, quality of life,
and increased bone mineral density and bone metabolism were also verified regardless
of the fracture sites and the administration types (oral or intravenous). Therefore,
more active BPs use is recommended to prevent recurrent fragility fractures.
Level of Evidence
Level I, meta-analysis.
Keywords
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Article info
Footnotes
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1189).
The authors declare no conflicts of interest.
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