Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis
Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis
Introduction: the objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis.
Methods: medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI).
Results: from the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k=10, n=2,992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD +4.75% (95% CI 3.45,6.05); total hip: MD +2.72% (95% CI 2.06;3.37); femoral neck: MD +2.26% (95% CI 1.67;2.85). Denososumab (k=2, n=242), Teriparatide (k=2, n=309) and Abaloparatide (k=2, n=248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures.
Conclusions: medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
Beaudart, Charlotte
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Demonceau, Celine
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Sabico, Shaun
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Veronese, Nicola
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Cooper, Cyrus
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Harvey, Nicholas
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Fuggle, Nicholas
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Bruyère, Olivier
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Rizzoli, René
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Reginster, Jean Yves
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Beaudart, Charlotte
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Demonceau, Celine
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Sabico, Shaun
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Veronese, Nicola
c4539c05-e941-46d2-8683-b7c9dc09b211
Cooper, Cyrus
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Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Fuggle, Nicholas
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Bruyère, Olivier
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Rizzoli, René
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Reginster, Jean Yves
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Beaudart, Charlotte, Demonceau, Celine, Sabico, Shaun, Veronese, Nicola, Cooper, Cyrus, Harvey, Nicholas, Fuggle, Nicholas, Bruyère, Olivier, Rizzoli, René and Reginster, Jean Yves
(2023)
Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis.
Aging Clinical and Experimental Research.
(In Press)
Abstract
Introduction: the objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis.
Methods: medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI).
Results: from the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k=10, n=2,992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD +4.75% (95% CI 3.45,6.05); total hip: MD +2.72% (95% CI 2.06;3.37); femoral neck: MD +2.26% (95% CI 1.67;2.85). Denososumab (k=2, n=242), Teriparatide (k=2, n=309) and Abaloparatide (k=2, n=248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures.
Conclusions: medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
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Treatment of OP for men_clean
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Accepted/In Press date: 7 June 2023
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Local EPrints ID: 477912
URI: http://eprints.soton.ac.uk/id/eprint/477912
ISSN: 1594-0667
PURE UUID: 77543c18-bb5e-4895-a2f7-aa40337d5d22
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Date deposited: 16 Jun 2023 16:37
Last modified: 18 Mar 2024 02:47
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Contributors
Author:
Charlotte Beaudart
Author:
Celine Demonceau
Author:
Shaun Sabico
Author:
Nicola Veronese
Author:
Olivier Bruyère
Author:
René Rizzoli
Author:
Jean Yves Reginster
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