PMID- 36433675
OWN - NLM
STAT- MEDLINE
DCOM- 20230314
LR  - 20230403
IS  - 1552-4604 (Electronic)
IS  - 0091-2700 (Linking)
VI  - 63
IP  - 4
DP  - 2023 Apr
TI  - Efficacy and Safety of Annual Infusion of Zoledronic Acid and Weekly Oral 
      Alendronate in the Treatment of Primary Osteoporosis: A Meta-Analysis.
PG  - 455-465
LID - 10.1002/jcph.2181 [doi]
AB  - This systematic review and meta-analysis aimed to reveal the efficacy and safety 
      of zoledronic acid compared with alendronate in patients with primary 
      osteoporosis. The PubMed, Embase, and the Cochrane Library databases were 
      searched from the establishment of each database to April 2022 for comparative 
      studies on the topic, including randomized controlled trials (RCTs) and cohort 
      studies, and 2 authors individually extracted information and data concerning 
      study design, baseline characteristics, bone mineral density (BMD), bone turnover 
      markers, and adverse events (AEs). We identified 8 eligible trials, including 
      1863 participants. Pooled estimates demonstrated that, compared with alendronate, 
      zoledronic acid showed no significant difference in increasing the BMD of the 
      lumbar spine after 1 year (SMD = -0.03, 95%CI -0.15 to 0.09, I(2)  = 0.41%) or 
      after 2 years (SMD = 0.16, 95%CI -0.12 to 0.43, I(2)  = 63%), and the BMD of the 
      total hip after 1 year (SMD = -0.08, 95%CI -0.31 to 0.14, I(2)  = 64%) or after 
      2 years (SMD = 0.05, 95%CI -0.21 to 0.32, I(2)  = 61%). No significant difference 
      in improving bone turnover markers, including serum C-terminal cross-linking 
      telopeptide of type-1 collagen, urine N-terminal cross-linking telopeptide of 
      type-1 collagen, and serum procollagen type-1 N-terminal propeptide, were found, 
      whereas significantly higher total AE rates (RR = 2.27, 95%CI 1.60 to 3.21, I(2) 
       = 75%) were recorded within 3 days of infusion, but some lower AE rates, 
      particularly of gastrointestinal AEs (RR = 0.6, 95%CI 0.44 to 0.83, I(2)  = 37%), 
      were noted after 3 days of infusion. Compared with alendronate, zoledronic acid 
      has achieved comparable therapeutic results in the treatment of primary 
      osteoporosis in increasing BMD and reducing bone turnover marker levels. 
      Zoledronic acid showed a better safety profile than alendronate with long-term 
      use, especially with regards to gastrointestinal-related AEs.
CI  - (c) 2023, The American College of Clinical Pharmacology.
FAU - Wang, Qiuling
AU  - Wang Q
AD  - Department of Pharmacy, Shenzhen University General Hospital, Shenzhen, China.
FAU - Yu, Qingzhen
AU  - Yu Q
AD  - Medical Research Center, Southern University of Science and Technology Hospital & 
      School of Medicine, Southern University of Science and Technology, Shenzhen, 
      China.
FAU - Zeng, Ping
AU  - Zeng P
AD  - Department of Pharmacy, Shenzhen University General Hospital, Shenzhen, China.
FAU - Ai, Weipeng
AU  - Ai W
AD  - Department of Pharmacy, Shenzhen University General Hospital, Shenzhen, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20230131
PL  - England
TA  - J Clin Pharmacol
JT  - Journal of clinical pharmacology
JID - 0366372
RN  - X1J18R4W8P (Alendronate)
RN  - 6XC1PAD3KF (Zoledronic Acid)
RN  - 0 (Diphosphonates)
RN  - 0 (Bone Density Conservation Agents)
SB  - IM
MH  - Humans
MH  - Female
MH  - Alendronate/adverse effects
MH  - Zoledronic Acid/therapeutic use
MH  - Diphosphonates/adverse effects
MH  - *Bone Density Conservation Agents/therapeutic use
MH  - Bone Density
MH  - *Osteoporosis/drug therapy
MH  - *Osteoporosis, Postmenopausal/drug therapy
OTO - NOTNLM
OT  - alendronate
OT  - efficacy
OT  - osteoporosis
OT  - safety
OT  - zoledronic acid
EDAT- 2022/11/27 06:00
MHDA- 2023/03/15 06:00
CRDT- 2022/11/26 02:32
PHST- 2022/07/11 00:00 [received]
PHST- 2022/11/01 00:00 [accepted]
PHST- 2022/11/27 06:00 [pubmed]
PHST- 2023/03/15 06:00 [medline]
PHST- 2022/11/26 02:32 [entrez]
AID - 10.1002/jcph.2181 [doi]
PST - ppublish
SO  - J Clin Pharmacol. 2023 Apr;63(4):455-465. doi: 10.1002/jcph.2181. Epub 2023 Jan 
      31.