Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Design

Editor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Meta-Analysis

The Effect of Bisphosphonates on Managing Osteoporosis After Spinal Cord Injury: A Meta-Analysis

Author(s): Ji Xinghua, Wang Junjie, Guo Yao, Shang Peng and Huo Jianzhong*

Volume 26, Issue 39, 2020

Page: [5072 - 5078] Pages: 7

DOI: 10.2174/1381612826666200504115747

Price: $65

Abstract

Background: The increased bone loss after spinal cord injury (SCI) is associated with an increase in the morbidity and mortality of fragility fractures, which can constitute a substantial cost to health care systems. Bisphosphonates (BPs) are now the principal class of medications used for osteoporosis.

Objective: To demonstrate the effect of BPs on treating osteoporosis after SCI.

Methods: A comprehensive search in PubMed, EMBASE, Web of Science and Cochrane Central databases was undertaken for randomized controlled trials (RCTs), exploring the effect of BPs on osteoporosis after SCI. The primary outcome measures were the BMD of different locations, serum bone turnover marker levels, serum biochemistry marker levels and adverse effect (AE) risks. The final search was performed in September 2019. Reporting was carried out according to PRISMA Guidelines.

Results: Six RCTs were included. A total of 147 patients met the inclusion criteria. BPs were found to statistically prevent bone loss in the total hip, femoral neck and trochanter at the 6- and 12-month follow-up points and to increase the BMD of the lumbar spine at the 12-month follow-up time point. BPs had no clear effect on serum PINP or serum calcium levels at the 12-month follow-up time point.

Conclusion: BP therapy may prevent bone loss in the lumbar spine and hip when administered early after SCI and has relatively high safety.

Keywords: Spinal cord injury, osteoporosis, bone mass density, bisphosphonates, meta-analysis, randomized controlled trials.

« Previous Next »
[1]
Kumar R, Lim J, Mekary RA, et al. Traumatic spinal injury: Global epidemiology and worldwide volume. World Neurosurg 2018; 113: e345-63.
[http://dx.doi.org/10.1016/j.wneu.2018.02.033] [PMID: 29454115]
[2]
Jiang SD, Dai LY, Jiang LS. Osteoporosis after spinal cord injury. Osteoporos Int 2006; 17(2): 180-92.
[http://dx.doi.org/10.1007/s00198-005-2028-8] [PMID: 16217589]
[3]
Jiang SD, Jiang LS, Dai LY. Mechanisms of osteoporosis in spinal cord injury. Clin Endocrinol (Oxf) 2006; 65(5): 555-65.
[http://dx.doi.org/10.1111/j.1365-2265.2006.02683.x] [PMID: 17054455]
[4]
Maïmoun L, Fattal C, Micallef JP, Peruchon E, Rabischong P. Bone loss in spinal cord-injured patients: from physiopathology to therapy. Spinal Cord 2006; 44(4): 203-10.
[http://dx.doi.org/10.1038/sj.sc.3101832] [PMID: 16158075]
[5]
Kanis JA, Cooper C, Rizzoli R, Reginster JY. Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Calcif Tissue Int 2019; 104(3): 235-8.
[http://dx.doi.org/10.1007/s00223-018-00512-x] [PMID: 30796490]
[6]
Gilchrist NL, Frampton CM, Acland RH, et al. Alendronate prevents bone loss in patients with acute spinal cord injury: a randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 2007; 92(4): 1385-90.
[http://dx.doi.org/10.1210/jc.2006-2013] [PMID: 17227802]
[7]
Goenka S, Sethi S, Pandey N, Joshi M, Jindal R. Effect of early treatment with zoledronic acid on prevention of bone loss in patients with acute spinal cord injury: A randomized controlled trial. Spinal Cord 2018; 56(12): 1207-11.
[http://dx.doi.org/10.1038/s41393-018-0195-7] [PMID: 30258212]
[8]
Bubbear JS, Gall A, Middleton FR, Ferguson-Pell M, Swaminathan R, Keen RW. Early treatment with zoledronic acid prevents bone loss at the hip following acute spinal cord injury. Osteoporos Int 2011; 22(1): 271-9.
[http://dx.doi.org/10.1007/s00198-010-1221-6] [PMID: 20358358]
[9]
Bauman WA, Wecht JM, Kirshblum S, et al. Effect of pamidronate administration on bone in patients with acute spinal cord injury. J Rehabil Res Dev 2005; 42(3): 305-13.
[http://dx.doi.org/10.1682/JRRD.2004.05.0062] [PMID: 16187243]
[10]
Schnitzer TJ, Kim K, Marks J, Yeasted R, Simonian N, Chen D. Zoledronic acid treatment after acute spinal cord injury: Results of a randomized, placebo-controlled pilot trial. PM R 2016; 8(9): 833-43.
[http://dx.doi.org/10.1016/j.pmrj.2016.01.012] [PMID: 26828618]
[11]
Shapiro J, Smith B, Beck T, et al. Treatment with zoledronic acid ameliorates negative geometric changes in the proximal femur following acute spinal cord injury. Calcif Tissue Int 2007; 80(5): 316-22.
[http://dx.doi.org/10.1007/s00223-007-9012-6] [PMID: 17417700]
[12]
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629-34.
[http://dx.doi.org/10.1136/bmj.315.7109.629] [PMID: 9310563]
[13]
Duque G. Osteoporosis in older persons: Current pharmacotherapy and future directions. Expert Opin Pharmacother 2013; 14(14): 1949-58.
[http://dx.doi.org/10.1517/14656566.2013.822861] [PMID: 23885760]
[14]
Murad MH, Drake MT, Mullan RJ, et al. Clinical review. Comparative effectiveness of drug treatments to prevent fragility fractures: a systematic review and network meta-analysis. J Clin Endocrinol Metab 2012; 97(6): 1871-80.
[http://dx.doi.org/10.1210/jc.2011-3060] [PMID: 22466336]
[15]
Soleyman-Jahi S, Yousefian A, Maheronnaghsh R, et al. Evidence-based prevention and treatment of osteoporosis after spinal cord injury: A systematic review. Eur Spine J 2018; 27(8): 1798-814.
[http://dx.doi.org/10.1007/s00586-017-5114-7] [PMID: 28497215]
[16]
Chang KV, Hung CY, Chen WS, Lai MS, Chien KL, Han DS. Effectiveness of bisphosphonate analogues and functional electrical stimulation on attenuating post-injury osteoporosis in spinal cord injury patients- a systematic review and meta-analysis. PLoS One 2013; 8(11)e81124
[http://dx.doi.org/10.1371/journal.pone.0081124] [PMID: 24278386]
[17]
Eastell R, Lang T, Boonen S, et al. HORIZON Pivotal Fracture Trial. Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial. Osteoporos Int 2010; 21(7): 1277-85.
[http://dx.doi.org/10.1007/s00198-009-1077-9] [PMID: 19802508]
[18]
Adams JE. Quantitative computed tomography. Eur J Radiol 2009; 71(3): 415-24.
[http://dx.doi.org/10.1016/j.ejrad.2009.04.074] [PMID: 19682815]
[19]
Zehnder Y, Risi S, Michel D, et al. Prevention of bone loss in paraplegics over 2 years with alendronate. J Bone Miner Res 2004; 19(7): 1067-74.
[http://dx.doi.org/10.1359/JBMR.040313] [PMID: 15176988]
[20]
Ruggiero S, Gralow J, Marx RE, et al. Practical guidelines for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in patients with cancer. J Oncol Pract 2006; 2(1): 7-14.
[http://dx.doi.org/10.1200/jop.2006.2.1.7] [PMID: 20871729]
[21]
Tadrous M, Mamdani MM, Juurlink DN, Krahn MD, Lévesque LE, Cadarette SM. Comparative gastrointestinal safety of bisphosphonates in primary osteoporosis: A network meta-analysis-reply to Pazianas and Abrahamsen. Osteoporos Int 2014; 25(11): 2671-2.
[http://dx.doi.org/10.1007/s00198-014-2789-z] [PMID: 25035138]
[22]
Chávez-Valencia V, Arce-Salinas CA, Espinosa-Ortega F. Cost-minimization study comparing annual infusion of zoledronic acid or weekly oral alendronate in women with low bone mineral density. J Clin Densitom 2014; 17(4): 484-9.
[http://dx.doi.org/10.1016/j.jocd.2013.12.001] [PMID: 24613450]
[23]
Shane E, Cohen A, Stein EM, et al. Zoledronic acid versus alendronate for the prevention of bone loss after heart or liver transplantation. J Clin Endocrinol Metab 2012; 97(12): 4481-90.
[http://dx.doi.org/10.1210/jc.2012-2804] [PMID: 23024190]
[24]
Orwoll ES, Miller PD, Adachi JD, Brown J, Adler RA, et al. Efficacy and safety of a once-yearly i.v. Infusion of zoledronic acid 5?mg versus a once-weekly 70-mg oral alendronate in the treatment of male osteoporosis A randomized, multicenter, double-blind, active- controlled study 25(10): 2239-50.

Rights & Permissions Print Cite
Article Metrics
54
1
World Health Day
© 2024 Bentham Science Publishers | Privacy Policy