骨化三醇+双膦酸盐治疗骨质疏松的疗效优于单纯双膦酸盐：一项荟萃分析。
The therapeutic effect to eldecalcitol + bisphosphonate is superior to bisphosphonate alone in the treatment of osteoporosis: a meta-analysis.
机构信息
Department of Pharmacy, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
Division of Medical Administration, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
出版信息
J Orthop Surg Res. 2020 Sep 9;15(1):390. doi: 10.1186/s13018-020-01896-z.
BACKGROUND
Osteoporosis is a metabolic bone disease. Bisphosphonate (BP) and eldecalcitol (ELD) are two clinical first-line drugs for osteoporosis patients. However, the effect of ELD + BP vs. BP alone on osteoporosis treatment is still unclear. The present meta-analysis was conducted to evaluate the different therapeutic effect of BP + ELD vs. BP alone in osteoporosis treatment.
METHODS
Eligible documents that selected from online databases including PubMed, Embase, and Cochrane Library were included in this study (updated to March 3, 2020). The quality assessment of the included studies was based on the guidelines of Cochrane. Meta-analysis was performed according to criteria such as intervention plan and outcome. The indicators including bone mineral density (BMD) in all enrolled studies were included in the current analysis. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CI) were calculated using fixed- or random-effects models. Then, heterogeneity analysis was performed based on Cochran's Q test and I statistics.
RESULTS
A total of 4 studies (456 cases) with high quality were enrolled in this study. The effect of ELD + BP was superior to BP alone based on indicators including femoral neck BMD (FN-BMD) and total hip BMD (TH-BMD) in patients with followed up ≤ 6 months. Moreover, the effect of ELD + BP was superior to BP alone based on lumbar spine BMD (LS-BMD) in patients with 12 months followed up.
CONCLUSION
Therapeutic effect of ELD + BP was superior to BP alone in osteoporotic patients based on the influence of BMD.
背景
骨质疏松症是一种代谢性骨病。双膦酸盐（BP）和骨化三醇（ELD）是骨质疏松症患者的两种临床一线药物。然而，ELD+BP 与单独使用 BP 对骨质疏松症治疗的效果仍不清楚。本荟萃分析旨在评估 ELD+BP 与单独使用 BP 在骨质疏松症治疗中的不同治疗效果。
方法
本研究纳入了来自 PubMed、Embase 和 Cochrane Library 等在线数据库的符合条件的文献（更新至 2020 年 3 月 3 日）。根据 Cochrane 指南对纳入研究进行质量评估。根据干预方案和结局等标准进行荟萃分析。目前的分析包括所有纳入研究的骨密度（BMD）指标。使用固定或随机效应模型计算汇总比值比（OR）和加权均数差（WMD）及其 95%置信区间（CI）。然后，根据 Cochran's Q 检验和 I 统计量进行异质性分析。
结果
本研究共纳入了 4 项高质量研究（456 例患者）。在随访时间≤6 个月的患者中，ELD+BP 在股骨颈 BMD（FN-BMD）和全髋关节 BMD（TH-BMD）等指标上的效果优于单独使用 BP；在随访时间为 12 个月的患者中，ELD+BP 在腰椎 BMD（LS-BMD）等指标上的效果也优于单独使用 BP。
结论
基于 BMD 的影响，ELD+BP 对骨质疏松症患者的治疗效果优于单独使用 BP。
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