Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis

Migliorini, Filippo; Maffulli, Nicola; Colarossi, Giorgia; Eschweiler, Jörg; Tingart, Markus; Betsch, Marcel

doi:10.1186/s13018-021-02678-x

Journal of Orthopaedic Surgery and Research

Table 1 Generalities and patients baseline of the included studies

From: Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis

Author, year	Journal	Follow-up (*months*)	Calcium daily supplement (mg)	Vit D daily supplement (UI)	Treatment	Administration	Samples (n)	Mean age	Mean BMI (*kg/m*²)	BMD Spine (*g/cm*²)	BMD Hip (*g/cm*²)	BMD Femur neck (*g/cm*²)
Anastasilakis et al. 2015 [29]	Osteoporos Int	12	1000	800	Denosumab	IM	32	63	28.80	0.97
					Zoledronate	IV	26	63	28.70	0.94
					Placebo	IV	241	57	23.73	0.92	0.65	0.63
Black et al. 2007 [30]	New England J Med	36	1000-1500	400-1200	Zoledronate	IV	3875	73	25.10	0.79	0.65	0.53
Black et al. 2007 [30]	New England J Med	36	1000-1500	400-1200	Placebo	IV	3861	73	25.40	0.79	0.65	0.53
Body et al. 2002 [31]	J Clin Endocrinol Metab	14	1000	400-1200	Alendronate	OS	73	65	24.40	0.80
Body et al. 2002 [31]	J Clin Endocrinol Metab	14	1000	400-1200	Teriparatide	SC	73	66	23.90	0.80
Black et al. 1996 [32]	The Lancet	36	652		Alendronate	OS	1022	71	25.50	0.79		0.57
Black et al. 1996 [32]	The Lancet	36	619		Placebo	OS	1005	71	25.60	0.79		0.56
Black et al. 2006 [33]	JAMA	60	655		Alendronate	OS	329	73	25.70	0.90	0.73	0.62
			667		Alendronate	OS	333	73	25.90	0.89	0.73	0.61
			635		Placebo	OS	437	74	25.80	0.90	0.72	0.61
Black et al. 2012 [34]	J Bone Min Res	36	1000-1500	400-1200	Zoledronate	IV	616	76	25.30	0.81	0.69	0.56
Black et al. 2012 [34]	J Bone Min Res	36	1000-1500	400-1200	Placebo	IV	617	76	25.60	0.82	0.69	0.57
Black et al. 2015 [35]	J Bone Min Res	36	1000-1500	400-1200	Zoledronate	IV	95	78	24.60		0.69	0.58
Black et al. 2015 [35]	J Bone Min Res	36	1000-1500	400-1200	Placebo	IV	95	78	25.00		0.71	0.58
Bone et al. 1997 [36]	J Clin Endocrinol Metab	24	813		Alendronate	OS	86	71
			880		Alendronate	OS	89	70
			831		Alendronate	OS	93	71
			900		Placebo	OS	91	71
Brown et al. 2014 [37]	Osteoporos Int	12			Denosumab	SC	852	68
					Ibandronate	OS	851	67
					Risedronate	OS	851	67
Brumsen et al. 2002 [38]	J Bone Min Res	60	500	400	Pamidronate	OS	26	66		0.76		0.64
Brumsen et al. 2002 [38]	J Bone Min Res	60	500	400	Placebo	OS	27	64		0.74		0.64
Chesnut et al. 2004 [39]	J Bone Min Res	36	500	400	Ibandronate	OS	977	69	26.20
					Ibandronate	OS	977	69	26.20
					Placebo	OS	975	69	26.20
Clemmesen et al. 1997 [40]	Osteoporos Int	36	1000		Risedronate	OS	44	67	25.50	0.80		0.61
					Risedronate/placebo	OS	44	68	24.40	0.79		0.61
					Placebo	OS	44	70	25.10	0.75		0.61
Cosman et al. 2016 [10]	New England J Med	12	500-1000	600-800	Romosozumab	SC	3589	71
		12	500-1000	600-800	Placebo	SC	3591	71
		24	500-1000	600-800	Denosumab	SC	3589	71
		24	500-1000	600-800	Denosumab	SC	3591	71
Cummings et al. 1998 [41]	JAMA	48	634		Alendronate	OS	2214	68	24.90	0.84		0.59
Cummings et al. 1998 [41]	JAMA	48	638		Placebo	OS	2218	68	25.00	0.84		0.59
Cummings et al. 2009 [42]	New England J Med	36	1000	400-800	Denosumab	SC	3902	72	26.00
Cummings et al. 2009 [42]	New England J Med	36	1000	400-800	Placebo	SC	3906	72	26.00
Delmas et al. 2002 [43]	J Clin Endocrinol Metab	48	500	400-600	Raloxifene	OS	2259	66	25.30	0.82		0.62
					Raloxifene	OS	2277	66	25.20	0.81		0.62
					Placebo	OS	2292	67	25.30	0.81		0.62
Ettinger et al. 1999 [7]	JAMA	36	500	400-600	Raloxifene	OS	2259	67
					Raloxifene	OS	2277
					Placebo	OS	2292
Fogelman et al. 2000 [44]	J Clin Endocrinol Metab	24	1000		Risedronate	OS	184	65	24.80	0.73		0.63
			1000		Risedronate	OS	177	65	24.80	0.75		0.64
					Placebo	OS	180	64	25.50	0.74		0.64
Frediani et al. 1998 [45]	Clin Drug Invest	24			Alendronate	OS	30	63	20.90	0.81
					Calcitriol	OS	30	63	21.80	0.81
					Alendronate/calcitriol	OS	30	63	21.00	0.80
					Calcium	OS	30	63	21.20	0.80
Garg et al. 2015 [46]	J South Asian Feder Menopause Soc	12			Zoledronate	IV	50
Garg et al. 2015 [46]	J South Asian Feder Menopause Soc	12			Teriparatide	SC	50
Gonnelli et al. 2014 [47]	Bone	12	841	400	Zoledronate	IV	30	66	26.10	0.82	0.79
Gonnelli et al. 2014 [47]		12	870		Ibandronate	IV	30	67	25.70	0.82	0.79
Greenspan et al. 2015 [48]	JAMA	24	807	163	Zoledronate	IV	89	85	28.20	0.93	0.68	0.61
Greenspan et al. 2015 [48]	JAMA	24	763	168	Placebo	IV	92	86	26.90	0.97	0.70	0.62
Grey et al. 2009 [49]	J Clin Endocrinol Metab	24	935		Zoledronate	IV	25	62		1.06	0.85
Grey et al. 2009 [49]	J Clin Endocrinol Metab	24	916		Placebo	IV	25	65		1.03	0.86
Grey et al. 2012 [50]	J Clin Endocrinol Metab	12	960		Zoledronate	IV	43	64		1.01	0.85
			880		Zoledronate	IV	43	66		1.03	0.84
			850		Zoledronate	IV	43	66		1.05	0.84
			950		Placebo	IV	43	65		1.03	0.87
Guanabens et al. 2013 [51]	Hepatology	24	1000		Ibandronate	OS	14	65	26.60	0.90	0.84	0.79
Guanabens et al. 2013 [51]	Hepatology	24	1000		Alendronate	OS	19	63	26.60	0.88	0.81	0.77
Harris et al. 1993 [52]	Am J Med	48	500		Phosphate-etidronate	OS	63			0.89		0.67
					Placebo-etidronate	OS	65			0.87		0.69
					Phosphate-placebo	OS	62			0.87		0.67
					Placebo	OS	63			0.86		0.68
Harris et al. 1999 [53]	JAMA	36	1000	500	Risedronate	OS	817	69	26.60	0.84		0.60
					Risedronate	OS	821	69	26.60	0.83		0.59
					Placebo	OS	820	68	26.50	0.83		0.60
Hooper et al. 2005 [54]	Climacteric	24			Risedronate	1OS	128	53		1.08
					Risedronate	OS	129	53		1.08
					Placebo	OD	126	53		1.08
Iwamoto et al. 2008 [55]	Yonsei Med J	12	800		Alendronate	OS	61	70	21.90	0.62
Iwamoto et al. 2008 [55]	Yonsei Med J	12	800		Raloxifene	OS	61	69	21.70	0.65
Kendler et al. 2019 [56]	Osteoporosis Int	12	> 1000	> 800	Romosozumab	SC	16	69
					Romosozumab	SC	19	68
					Romosozumab	SC	14
					Romosozumab	SC	12
Langdahl et al. 2017 [57]	The Lancet	12	500-1000	600-800	Romosozumab	SC	198	72
Langdahl et al. 2017 [57]	The Lancet	12	500-1000	600-800	Teriparatide	SC	200	71
Leder et al. 2015 [58]	The Lancet	48			Teriparatide-denosumab	SC	27	66	25.50	0.82		0.64
					Denosumab-teriparatide	SC	27	65	23.80	0.86		0.64
					Combined-denosumab	SC	23	65	25.90	0.85		0.64
Leder et al. 2014 [59]	J Clin Endocrinol Metab	24			Teriparatide	SC	31	66	25.50	0.82		0.64
					Denosumab	SC	33	66	24.10	0.87		0.64
					Combined	SC	30	66	25.40	0.86		0.64
Lewiecki et al. 2018 [60]	J Clin Endocrinol Metab	12			Denosumab	SC	3003	71	24.70
Lewiecki et al. 2018 [60]	J Clin Endocrinol Metab	12			Denosumab	SC	3042	71	24.70
Liang et al. 2017 [61]	Orthop Surg	24			Zoledronate	IV	155	57	21.80	0.63	0.75
					Placebo	IV	95	57	21.60	0.63	0.75
					Placebo	OS	355	64	24.10
Lufkin et al. 1998 [62]	J Bone Min Res	12			Raloxifene	OS	48	67	24.80	0.75	0.64
					Raloxifene	OS	47	67	26.20	0.81	0.69
			750	400	Calcium/vit D	OS	48	68	25.30	0.77	0.67
Lyritis et al. 1997 [63]	Clin Rheumatol	48	500		Etidronate	OS	39	72	27.60	0.57		0.42
Lyritis et al. 1997 [63]	Clin Rheumatol	48			Calcium/vit D	OS	35	72	26.80	0.57		0.43
McClung et al. 2014 [64]	New England J Med	12	1000	800	Romosozumab	SC	44	67
					Romosozumab	SC	46	67
					Romosozumab	SC	49	67
					Romosozumab	SC	52	67
					Romosozumab	SC	53	67
					Alendronate	OS	47	67
					Teriparatide	SC	46	67
					Placebo	SC	47	67
McClung et al. 2009 [65]	ObstetGynecol	24	500-1200	400-800	Zoledronate	IV	181	60	26.50	0.86		0.69
					Zoledronate-placebo	IV	154	60	27.30	0.86		0.69
					Placebo	IV	188	61	27.20	0.86		0.69
McClung et al. 2018 [66]	J Bone Min Res	12	1000	800	Denosumab	SC	127	67
McClung et al. 2018 [66]	J Bone Min Res	12	1000	800	Placebo	SC	131	67
Meunier et al. 2004 [67]	New England J Med	36	1000	400-800	Strontium ranelate	OS	719	69	26.20	0.73	0.69	0.59
Meunier et al. 2004 [67]	New England J Med	36	1000	400-800	Placebo	OS	723	69	26.20	0.72	0.68	0.59
Meunier et al. 2009 [68]	Osteoporos Int	12	1000	400-800	Strontium ranelate	OS	221	72		0.85		0.66
					Strontium ranelate	OS	434	72		0.72		0.58
					Placebo	OS	225	72		0.86		0.64
Miller et al. 2016 [69]	J Clin Endocrinol Metab	12	1000	800	Denosumab	SC	321	69	24.30
Miller et al. 2016 [69]	J Clin Endocrinol Metab	12	1000	800	Zoledronate	IV	322	70	24.30
Miyauchi et al. 2019 [68]	Arch Osteoporos	36	500-1000	600-800	Denosumab	SC	247	71	21.10
Miyauchi et al. 2019 [68]	Arch Osteoporos	36	500-1000	600-800	Denosumab	SC	245	70	21.40
Montessori et al. 1997 [70]	Osteoporos Int	36			Etidronate	OS	40	62		0.68	0.67	0.60
Montessori et al. 1997 [70]	Osteoporos Int	36			Calcium	OS	40	63		0.67	0.69	0.61
Morii et al. 2003 [71]	Osteoporos Int	13			Raloxifene	OS	90	65	21.50	0.66
					Raloxifene	OS	93	65	21.90	0.67
					Placebo	OS	97	64	22.00	0.64
Mortensen et al. 1998 [72]	J Clin Endocrinol Metab	36	937		Risedronate	OS	37	52		0.93		0.74
			1057		Risedronate	OS	38	51		0.93		0.71
			936		Placebo	OS	36	51		0.96		0.74
Neer et al. 2001 [73]	New England J Med	24	1000	400-1200	Teriparatide	SC	444	69		0.82	0.70	0.64
					Teriparatide	SC	434	70		0.82	0.70	0.64
					Placebo	SC	448	69		0.82	0.71	0.64
Paggiosi et al. 2014 [74]	Osteoporos Int	24	1200	800	Alendronate	OS	57	68	25.90	0.79	0.75	0.64
					Ibandronate	OS	58	67	26.40	0.80	0.78	0.64
					Risedronate	OS	57	67	26.80	0.81	0.80	0.67
					Control		226	38	25.10	1.,07	0.97	0.86
Papapoulos et al. 2012 [75]	J Bone Min Res	24			Denosumab	SC	2343	75
Papapoulos et al. 2012 [75]	J Bone Min Res	24			Denosumab	SC	2207	75
Papapoulos et al. 2015 [76]	Osteoporos Int	60	> 1000	> 400	Denosumab	SC	2343	79
Papapoulos et al. 2015 [76]	Osteoporos Int	60	> 1000	> 400	Denosumab	SC	2207	79
Popp e t al. 2013 [77]	Maturitas	36	1000-1500	400-1200	Zoledronate	IV	55	77	24.60	0.77	0.67	0.56
Popp e t al. 2013 [77]	Maturitas	36	1000-1500	400-1200	Placebo	IV	55	77	24.40	0.77	0.67	0.55
Recknor et al. 2013 [26]	ObstetGynecol	12	500	800	Denosumab	SC	417	67	25.50
Recknor et al. 2013 [26]	ObstetGynecol	12			Ibandronate	OS	416	66	25.10
Reginster et al. 2009 [78]	Osteoporos Int	36	500-1000	400-800	Strontium ranelate	OS	879	79	25.90	0.93	0.73	0.61
Reginster et al. 2009 [78]	Osteoporos Int	36	500-1000	400-800	Control	OS	892	74	25.90	0.77	0.67	0.57
Reginster et al. 2011 [79]	Osteoporos Int	60	500-1000	400-800	Strontium ranelate	OS	233	77	25.80	0.76	0.69	0.58
Reginster et al. 2011 [79]	Osteoporos Int	60	500-1000	400-800	Placebo	OS	458	76	25.20
Roux et al. 2014 [80]	Bone	12	≥ 1000	≥ 800	Denosumab	SC	435	68
Roux et al. 2014 [80]	Bone	12	≥ 1000	≥ 800	Risedronate	OS	435	68
Saag et al. 2017 [11]	New England J Med	24			Alendronate	OS	2047	74	25.40
Saag et al. 2017 [11]	New England J Med	24			Romosozumab-alendronate	SC-OS	2046	74	25.50
Tsai et al. 2013 [81]	The Lancet	12			Teriparatide	SC	31	66	25.50	0.82	0.76	0.64
					Denosumab	SC	33	66	24.10	0.87	0.77	0.64
					Teriparatide/denosumab	SC	30	66	25.40	0.86	0.76	0.64
Tsai et al. 2019 [82]	The Lancet	15			Teriparatide-denosumab	SC	35	66	23.00	0.83	0.74	0.65
Tsai et al. 2019 [82]	The Lancet	15			Teriparatide-denosumab	SC	34	67	22.80	0.79	0.74	0.62
Tucci et al. 1996 [83]	Am J Med	36	500		Alendronate	OS	98	67	23.90
					Alendronate	OS	94	64	23.30
					Alendronate	OS	94	64	23.70
					Placebo	OS	192	64	23.80
Jiang et al. 2003 [84]	J Bone Min Res	19	1000	400-1200	Teriparatide	SC	18	68		0.77		0.61
					Teriparatide	SC	14	68		0.84		0.62
					Placebo	SC	19	68		0.86		0.65

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