Meunier P J
Department of Rheumatology and Bone Diseases, Edouard Herriot Hospital, Lyon, France.
Int J Clin Pract. 1999 Mar;53(2):122-9.
The goal of osteoporosis therapy is to prevent fractures, and many therapies are available for this disease. Regarding proven fracture benefit, however, the quality of the randomised clinical trial evidence varies substantially among therapies. The purpose of this paper is, therefore, to review the published osteoporosis randomised clinical trial literature and to assess the quality of the evidence. Although more than 35 randomised trials for different therapies were reviewed, only alendronate and vitamin D plus calcium have clearly demonstrated a fracture benefit, with alendronate providing the greatest relative risk reduction. Quality clinical trial fracture data for calcitonin, etidronate, fluoride, hormone replacement therapy, parathyroid hormone, calcitriol (and other vitamin D preparations), vitamin D and calcium monotherapy, and selective oestrogen receptor modulators are either lacking or inconclusive or published only as abstracts.
骨质疏松症治疗的目标是预防骨折，针对这种疾病有多种治疗方法。然而，就已证实的骨折获益而言，不同治疗方法的随机临床试验证据质量差异很大。因此，本文的目的是回顾已发表的骨质疏松症随机临床试验文献，并评估证据质量。尽管对超过35项针对不同治疗方法的随机试验进行了回顾，但只有阿仑膦酸钠以及维生素D加钙明确显示出对骨折的获益，其中阿仑膦酸钠降低相对风险的幅度最大。降钙素、依替膦酸二钠、氟化物、激素替代疗法、甲状旁腺激素、骨化三醇（及其他维生素D制剂）、维生素D和钙单一疗法以及选择性雌激素受体调节剂的高质量临床试验骨折数据要么缺乏，要么不确定，要么仅以摘要形式发表。
