Article type
Year
Abstract
Objective: To determine the efficacy of bisphosphonates in the prevention and treatment of steroid induced osteoporosis.
Methods: We conducted a systematic review of the literature regarding prevention and treatment of steroid induced osteoporosis, using Medline (1966-1997) and Embase (1988-1997). The search strategy and data extraction followed the Cochrane collaboration approach. Controlled clinical trials were identified, and those pertaining to bisphosphonates were selected for review. The outcome of interest was the percent change in bone mineral density, from baseline, measured at the lumbar spine. We were interested in trials of six or twelve months duration. Information regarding bone mineral density at other sites, fracture rates, and biochemical markers of bone loss was extracted if present.
Results: There were six randomized clinical trials that met the inclusion criteria, with data on a total of 206 subjects. Mean percent change in bone mineral density with standard deviation was used to estimate overall effects for the treatment and placebo groups. A fixed effects model was used to summarize the data and resulted in a weighted mean difference between the two groups. The data below refers to changes in bone mass at the lumbar spine.
Time Point Weighted Mean Difference (95% CI)
6 months 4.5(3.6,5.3)
12 months 6.8(5.8,7.8)
Discussion: This analysis provides evidence for the efficacy of bisphosphonates in the prevention of steroid-induced osteoporosis at the lumbar spine.
Methods: We conducted a systematic review of the literature regarding prevention and treatment of steroid induced osteoporosis, using Medline (1966-1997) and Embase (1988-1997). The search strategy and data extraction followed the Cochrane collaboration approach. Controlled clinical trials were identified, and those pertaining to bisphosphonates were selected for review. The outcome of interest was the percent change in bone mineral density, from baseline, measured at the lumbar spine. We were interested in trials of six or twelve months duration. Information regarding bone mineral density at other sites, fracture rates, and biochemical markers of bone loss was extracted if present.
Results: There were six randomized clinical trials that met the inclusion criteria, with data on a total of 206 subjects. Mean percent change in bone mineral density with standard deviation was used to estimate overall effects for the treatment and placebo groups. A fixed effects model was used to summarize the data and resulted in a weighted mean difference between the two groups. The data below refers to changes in bone mass at the lumbar spine.
Time Point Weighted Mean Difference (95% CI)
6 months 4.5(3.6,5.3)
12 months 6.8(5.8,7.8)
Discussion: This analysis provides evidence for the efficacy of bisphosphonates in the prevention of steroid-induced osteoporosis at the lumbar spine.