Sun Jianfeng, Rahmati Masoud, Xie Wenqing, Yang Guang, Ji Bingzhou, Yon Dong Keon, Lee Seung Won, Gyasi Razak M, López Sánchez Guillermo F, Soysal Pinar, Koyanagi Ai, Smith Lee, Shin Jae Il, Li Yusheng
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China.
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran.
Heliyon. 2024 Jun 29;10(13):e33871. doi: 10.1016/j.heliyon.2024.e33871. eCollection 2024 Jul 15.
Zoledronic acid can inhibit the activity of osteoclasts, and thus, may slow or inhibit bone loss. The purpose of this study was to systematically evaluate the efficacy and safety of zoledronic acid in the treatment of osteoporosis.
Four databases, PubMed, Embase, Cochrane Library, and Web of Science, were systematically searched up to December 26, 2022. The primary outcomes included bone mineral density (BMD), carboxy-terminal cross-linked telopeptide of type 1 collagen (CTX), bone-specific alkaline phosphatase (BSAP), procollagen type 1 N-terminal prope-ptide (P1NP), adverse events, and fracture. Secondary outcomes included serum sclerostin level, Visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI).
A total of 22 randomized controlled trials were included in this meta-analysis. Meta-analysis results showed that zoledronic acid was effective in increasing BMD of the lumbar spine, femoral neck, trochanter and serum sclerostin level; and reduced CTX, BSAP, P1NP, VAS score, and ODI in patients with osteoporosis. Regarding safety, zoledronic acid could reduce the incidence of fractures but had relatively more adverse events.
Zoledronic acid can significantly improve BMD of the lumbar spine, femoral neck and trochanter, and effectively reduce incidence of fracture in patients with osteoporosis, thereby significantly improving patients' quality of life. However, the incidence of adverse events was higher than that of patients treated with placebo.
唑来膦酸可抑制破骨细胞活性，因此可能减缓或抑制骨质流失。本研究旨在系统评价唑来膦酸治疗骨质疏松症的疗效和安全性。
系统检索截至2022年12月26日的四个数据库，即PubMed、Embase、Cochrane图书馆和Web of Science。主要结局指标包括骨密度（BMD）、Ⅰ型胶原羧基末端交联肽（CTX）、骨特异性碱性磷酸酶（BSAP）、Ⅰ型前胶原N端前肽（P1NP）、不良事件和骨折。次要结局指标包括血清硬化蛋白水平、视觉模拟评分法（VAS）评分和Oswestry功能障碍指数（ODI）。
本荟萃分析共纳入22项随机对照试验。荟萃分析结果显示，唑来膦酸可有效提高腰椎、股骨颈、大转子的骨密度及血清硬化蛋白水平；降低骨质疏松症患者的CTX、BSAP、P1NP、VAS评分和ODI。在安全性方面，唑来膦酸可降低骨折发生率，但不良事件相对较多。
唑来膦酸可显著提高腰椎、股骨颈和大转子的骨密度，有效降低骨质疏松症患者的骨折发生率，从而显著改善患者生活质量。然而，其不良事件发生率高于安慰剂治疗患者。
