Comparative effectiveness of drug treatments to prevent fragility fractures: A systematic review and network meta-analysis
Mohammad Hassan Murad,Matthew T. Drake,Rebecca J. Mullan,Karen F. Mauck,Louise M. Stuart,Melanie A. Lane,Nisrin O. Abu Elnour,Patricia J. Erwin,Ahmad Hazem,Milo A. Puhan,Tianjing Li,Victor M. Montori +11 more
TLDR
Differences in efficacy across drugs are small; therefore, patients and clinicians need to consider their associated harms and costs.Abstract:
Context: Osteoporosis and osteopenia are associated with increased fracture incidence. Objective: The aim of this study was to determine the comparative effectiveness of different pharmacological agents in reducing the risk of fragility fractures. Data Sources: We searched multiple databases through 12/9/2011. Study Selection: Eligible studies were randomized controlled trials enrolling individuals at risk of developing fragility fractures and evaluating the efficacy of bisphosphonates, teriparatide, selective estrogen receptor modulators, denosumab, or calcium and vitamin D. Data Extraction: Reviewers working independently and in duplicate determined study eligibility and collected descriptive, methodological quality, and outcome data. Data Synthesis: This network meta-analysis included 116 trials (139,647 patients; median age, 64 yr; 86% females and 88% Caucasians; median follow-up, 24 months). Trials were at low to moderate risk of bias. Teriparatide had the highest risk reduction of fractures (odds ra...read more
Citations
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A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis
Milo A. Puhan,Holger J. Schünemann,Mohammad Hassan Murad,Tianjing Li,Romina Brignardello-Petersen,Jasvinder A. Singh,Alfons G.H. Kessels,Gordon H. Guyatt +7 more
TL;DR: It is shown that the quality of evidence supporting NMA estimates varies from high to very low across comparisons, and that quality ratings given to a whole network are uninformative and likely to mislead.
Journal ArticleDOI
Managing Osteoporosis in Patients on Long-Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research.
Robert A. Adler,Ghada El-Hajj Fuleihan,Douglas C. Bauer,Pauline M. Camacho,Bart L. Clarke,Gregory A. Clines,Juliet E. Compston,Matthew T. Drake,Beatrice J. Edwards,Murray J. Favus,Susan L. Greenspan,Ross E. McKinney,Robert J. Pignolo,Deborah E. Sellmeyer +13 more
TL;DR: The ASBMR Task Force suggests that after 5 years of oral BP or 3 years of intravenous BP, reassessment of risk should be considered, and in women at high risk, older women, those with a low hip T-score or high fracture risk score, or who fracture on therapy, continuation of treatment for up to 10 years (oral) or 6 years (intravenous), with periodic evaluation, should be consideration.
Journal ArticleDOI
Osteoporosis in men: an Endocrine Society clinical practice guideline.
Nelson B. Watts,Robert A. Adler,John P. Bilezikian,Matthew T. Drake,Richard Eastell,Eric S. Orwoll,Joel S. Finkelstein +6 more
TL;DR: Osteoporosis in men causes significant morbidity and mortality and Pharmacological treatment is recommended for men aged 50 or older who have had spine or hip fractures, those with T-scores of -2.5 or below, and men at high risk of fracture based on low bone mineral density and/or clinical risk factors.
Journal ArticleDOI
Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians
TL;DR: This guideline updates the 2008 American College of Physicians recommendations on treatment of low bone density and osteoporosis to prevent fractures in men and women and recommends that clinicians should make the decision whether to treat osteopenic women 65 years of age or older who are at a high risk for fracture based on a discussion of patient preferences, fracture risk profile, and benefits, harms, and costs of medications.
Journal ArticleDOI
Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis
Romina Brignardello-Petersen,Ashley Bonner,Paul E. Alexander,Reed A C Siemieniuk,Toshi A. Furukawa,Bram Rochwerg,Glen Hazlewood,Waleed Alhazzani,Reem A. Mustafa,M. Hassan Murad,Milo A. Puhan,Holger J. Schünemann,Gordon H. Guyatt +12 more
TL;DR: Conceptual advances of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group guidance to evaluate the certainty of evidence from network meta-analysis (NMA) are described.
References
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