二膦酸盐类药物治疗继发性甲状旁腺功能亢进透析患者骨折的疗效：随机试验的荟萃分析。
Effectiveness of calcimimetics on fractures in dialysis patients with secondary hyperparathyroidism: meta-analysis of randomized trials.
机构信息
Department of Nephrology and Rheumatology, Niigata City General Hospital, Niigata, Japan.
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan.
出版信息
J Bone Miner Metab. 2024 May;42(3):316-325. doi: 10.1007/s00774-024-01500-y. Epub 2024 Mar 27.
INTRODUCTION
This study aimed to assess the effectiveness of calcimimetics in reducing the risk of fractures in dialysis patients with secondary hyperparathyroidism (SHPT).
MATERIAL AND METHODS
A comprehensive literature search was conducted using PubMed, Embase, and Cochrane Library for articles published through December 9, 2023. The quality of each trial was evaluated using the Cochrane Collaboration tool. Meta-analysis was performed using a random-effects model, and effect measures across studies were synthesized. The risk ratio (RR) and 95% confidence interval (CI) were used to quantify the risk of fracture.
RESULTS
We identified seven studies involving 6481 dialysis patients with SHPT. The administration of calcimimetics reduced fracture incidence compared to placebo or conventional treatment (RR: 0.50, 95% CI 0.29-0.88, p = 0.02). Calcimimetics demonstrated a low number needed to treat (NNT) to prevent an incident fracture (NNT: 47).
CONCLUSION
The use of calcimimetics offers a significant benefit in reducing the risk of fractures in patients undergoing dialysis with SHPT.
简介
本研究旨在评估钙敏感受体激动剂在降低继发性甲状旁腺功能亢进（SHPT）透析患者骨折风险方面的有效性。
材料和方法
通过 PubMed、Embase 和 Cochrane Library 对截至 2023 年 12 月 9 日发表的文章进行了全面的文献检索。使用 Cochrane 协作工具评估了每项试验的质量。使用随机效应模型进行荟萃分析，并综合了研究间的效应量。风险比（RR）和 95%置信区间（CI）用于量化骨折风险。
结果
我们确定了 7 项涉及 6481 例 SHPT 透析患者的研究。与安慰剂或常规治疗相比，钙敏感受体激动剂可降低骨折发生率（RR：0.50，95%CI 0.29-0.88，p=0.02）。钙敏感受体激动剂显示出预防骨折事件所需的治疗人数（NNT）较低（NNT：47）。
结论
钙敏感受体激动剂的使用可显著降低 SHPT 透析患者骨折风险。
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