Evidence Hub

Adverse Gastrointestinal Effects of Alendronate Versus Risedronate in Osteoporosis: A Systematic Review and Meta-analysis

Nouh MI, Albuti H, Hasosah M, Karrar HR, Ashgar RE, Nouh YI, Alhendi RSA, Omaish TM et al.

Annals of African medicine, 2026

4,151 participants

Abstract

Abstract: Bisphosphonates (BPs; alendronate and risedronate) have been approved as a therapy for osteoporosis. While the efficacy of these drugs appears similar, differences in safety and gastrointestinal tract (GIT) adverse effects are lacking. Consequently, a systematic review and a meta-analysis were carried out reporting on the incidence rate of GIT adverse effects and the safety of alendronate versus risedronate. In this study, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. This study collected articles from Embase, PubMed, Cochrane library, and Web of Science. Only RCTs that focused on the comparison between alendronate and risedronate in treating patients with osteoporosis were included. Risk ratios (RRs), 95% confidence intervals (CIs), and random-effects model were calculated. This meta-analysis identified 2202 studies including 4151 participants. There were six eligible RCTs. The incidence rate of GIT adverse effects in patients who received alendronate was 20.19%, while the incidence rate in patients who received risedronate was 18.30%. The rate of GIT adverse effects was not significantly different with alendronate compared to risedronate (RR: 1.11; 95% CI: 0.86-1.42; P < 0.44). In this review, the incidence rate of alendronate-associated gastrointestinal (GI) adverse effects was slightly higher than the incidence rate of risedronate-associated GI adverse effects. Although the finding is not statistically significant,…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 4,151 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free