II. Meta-Analysis of Alendronate for the Treatment of Postmenopausal Women
Abstract
Objective: To review the effect of alendronate on bone density and fractures in postmenopausal women. Data Source: We searched MEDLINE, EMBASE, Current Contents, and the Cochrane Controlled trials registry from 1980 to 1999, and we examined citations of relevant articles and proceedings of international meetings. Study Selection: We included 11 trials that randomized women to alendronate or placebo and measured bone density for at least 1 yr. Data Extraction: For each trial, three independent reviewers assessed the methodological quality and abstracted data. Data Synthesis: The pooled relative risk (RR) for vertebral fractures in patients given 5 mg or more of alendronate was 0.52 [95% confidence interval (CI), 0.43–0.65]. The RR of nonvertebral fractures in patients given 10 mg or more of alendronate was 0.51 (95% CI 0.38–0.69), an appreciably greater effect than for the 5 mg dose. We found a similar reduction in RR across nonvertebral fracture types; in particular, RR reductions for fractures traditionally thought to be “osteoporotic,” such as hip and forearm, were very similar to RR reductions for “nonosteoporotic” fractures. Individual studies showed similar results, reflected in the P values of the test of heterogeneity (P = 0.99 for vertebral and 0.88 for nonvertebral fractures). Alendronate produced positive effects on the percentage change in bone density, which increased with both dose and time. After 3 yr of treatment with 10 mg of alendronate or more, the pooled…
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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: 12,855 participants or records.
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