In:
Hormone and Metabolic Research, Georg Thieme Verlag KG, Vol. 55, No. 04 ( 2023-04), p. 236-244
Abstract:
Osteoporosis (OP) is characterized as decreased bone mineral density (BMD) and
increased risk of bone fracture. Secondary OP resulting from excess endogenous or exogenous glucocorticoid is defined as glucocorticoid-induced osteoporosis
(GIOP). Current therapeutic strategies for GIOP are similar to menopausal osteoporosis, including calcium and vitamin D supplementation, bisphosphonates,
and parathyroid hormone (PTH) analogues (teriparatide). Previously, several published meta-analyses compared anti-osteoporotic agents for the menopausal or
aging-dependent OP. However, the physiopathologic bone metabolism of GIOP is different. In this study, we investigated the efficacy of BMD enhancement, bone
fracture rate and safety of bisphosphonates versus teriparatide in the therapy of GIOP. We searched databases including PubMed, Embase, and the Cochrane
Library until Jan 2023, and selected ten random clinical trials (RCT)s that compared the efficacy and/or safety of bisphosphonate versus
teriparatide for GIOP patients. Teriparatide therapy increased lumber spinal BMD by 3.96% (95% CI 3.01–4.9%, p 〈 0.00001),
1.23% (95% CI 0.36–2.1%, p=0.006) at total hip, and 1.45% (95% CI 0.31–2.58%,
p=0.01) at femoral neck, respectively, compared to bisphosphonates at 18-month therapy for GIOP. Teriparatide also reduced bone fracture especially in
vertebral bone (p=0.0001, RR 6.27, 95% CI 2.44–16.07), and increased bone formation and resorption marker levels. There was no
difference in the incidence of adverse effects in bisphosphonate and teriparatide groups. Teriparatide showed better performance over bisphosphonate
in BMD enhancement, bone fracture reduction, and bone remodeling improvement, without increasing the incidence of adverse effects.
Type of Medium:
Online Resource
ISSN:
0018-5043
,
1439-4286
Language:
English
Publisher:
Georg Thieme Verlag KG
Publication Date:
2023
detail.hit.zdb_id:
2056576-8
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