丹诺苏马布与双酸盐在原发性骨质疏松症中:随机对照试验中的比较安全性的元分析
Takaomi Kobayashi1,2,3,4, Tadatsugu Morimoto5, Koji Ito6,5
1Department of Orthopaedic Surgery, Taku City Hospital, Saga, Japan. takaomi_920@yahoo.co.jp.
概括
与初级骨质疏松症中的双酸盐相比,德诺苏马布由于不良事件 (AEs) 的退出较少,但心血管事件和感染增加. 由于试验偏见,需要进一步研究.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 类风湿病学 类风湿病学
背景情况:
- 初级骨质疏松症管理通常涉及德诺苏马布和双酸盐.
- 这些治疗原发性骨质疏松症的治疗方法之间的安全性比较数据有限.
研究的目的:
- 在患有原发性骨质疏松症的患者中对代诺苏马布和双酸盐的安全性进行比较的元分析.
- 为了确定与每种治疗相关的特定不良事件.
主要方法:
- 在PubMed和谷歌学者的系统搜索中,确定了相关的随机对照试验,这些试验发表在2023年12月之前.
- 包括11项试验,涉及5545名患者,随访时间为12-24个月.
- 数据使用固定或随机效应模型进行聚合,以计算不良事件的风险比率 (RR) 和95%置信区间 (CI).
主要成果:
- 与双酸盐相比,德诺苏马布与因不良事件 (RR=0.49) 和较少的脊椎骨折 (RR=0.54) 和腹部疼痛 (RR=0.44) 的戒断相关.
- 相反,德诺苏马布显示主要心血管不良事件 (RR=2.05),心血管AE (RR=1.61),感染 (RR=1.14) 和上呼吸道感染 (RR=1.56) 的风险更高.
- 所有纳入的试验都表现出一些偏差风险,影响了二次终点和随机化.
结论:
- 德诺苏马布和双酸盐在原发性骨质疏松症中具有不同的安全性.
- 虽然德诺苏马布可以减少治疗中止和脊椎骨折,但它与心血管事件和感染的增加有关.
- 试验中存在偏差需要进一步调查以验证这些比较安全性发现.
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