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Effect of bisphosphonate on hip fracture in patients with osteoporosis or osteopenia according to age: a meta-analysis and systematic review

Sichun Zhao, Wen Zhao, Dongpeng Du, Chunhao Zhang, Tao Zhao, Liwen Zheng, Leiming Jin, Minghao Gu, Junfeng Xu, Zhonghua Yang
DOI: 10.1136/jim-2021-001961 Published 25 February 2022
Sichun Zhao
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Wen Zhao
2 Department of Clinical Immunology, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China
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Dongpeng Du
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Chunhao Zhang
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Tao Zhao
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Liwen Zheng
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Leiming Jin
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Minghao Gu
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Junfeng Xu
1 Department of Orthopedics, Chengdu BOE Hospital, Chengdu, Sichuan, China
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Zhonghua Yang
3 Department of Geriatrics, Sichuan University West China Hospital, Chengdu, Sichuan, China
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Abstract

This meta-analysis and systematic review investigated the efficacy of bisphosphonates on the incidence of hip fracture (IHF) in patients of different ages with osteoporosis or osteopenia. We searched Web of Science, Embase, the Cochrane Database, and PubMed from inception to January 10, 2021, for trials reporting the effects of bisphosphonates on the IHF. We included only randomized, double-blind, placebo-controlled clinical trials. We pooled data using a random-effects meta-analysis with risk ratios (RRs) and reported 95% CIs. We also used the Cochran Q and I² statistics to assess the heterogeneity in the results of individual studies. The primary endpoints were the total numbers of people in the bisphosphonates and placebo groups and the numbers of IHFs during the follow-up periods. Bisphosphonates reduced the IHF with an overall effect (RR: 0.66; 95% CI: 0.56 to 0.77; zoledronic acid: RR: 0.60; 95% CI: 0.46 to 0.78; risedronate: RR: 0.74; 95% CI: 0.59 to 0.94, and alendronate: RR: 0.61; 95% CI: 0.40 to 0.95). The result of the heterogeneity assessment was I²=0, p=0.97. In all age groups (all ages, ≥55 years old, ≥65 years old), bisphosphonates reduced the IHF. In the ≥55 years old and ≥65 years old age groups, the RR and 95% CI were 0.63 and 0.43 to 0.93, and 0.60 and 0.44 to 0.81, respectively. Bisphosphonate reduced the IHF in the general population and all age groups (≥55 years old and ≥65 years old). Zoledronic acid, risedronate and alendronate reduced the IHF in osteoporosis or osteopenia populations. The association between bisphosphonate and the IHF does not appear to be influenced by age.

Footnotes

  • Contributors SZ, CZ, and DD conceived and designed the experiments. SZ, TZ, and JX performed the experiments. SZ, LZ, and WZ analyzed the data. ZY, LJ, and MG contributed reagents/materials/analysis tools. SZ wrote the paper. SZ is the guarantor of the entire study.

  • Funding This study was supported by the project of the Science and Technology Department in Sichuan province (2011FZ0115).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information.

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Vol 70 Issue 3 Table of Contents
Journal of Investigative Medicine: 70 (3)
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Effect of bisphosphonate on hip fracture in patients with osteoporosis or osteopenia according to age: a meta-analysis and systematic review
Sichun Zhao, Wen Zhao, Dongpeng Du, Chunhao Zhang, Tao Zhao, Liwen Zheng, Leiming Jin, Minghao Gu, Junfeng Xu, Zhonghua Yang
Journal of Investigative Medicine Mar 2022, 70 (3) 837-843; DOI: 10.1136/jim-2021-001961

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Effect of bisphosphonate on hip fracture in patients with osteoporosis or osteopenia according to age: a meta-analysis and systematic review
Sichun Zhao, Wen Zhao, Dongpeng Du, Chunhao Zhang, Tao Zhao, Liwen Zheng, Leiming Jin, Minghao Gu, Junfeng Xu, Zhonghua Yang
Journal of Investigative Medicine Mar 2022, 70 (3) 837-843; DOI: 10.1136/jim-2021-001961
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Effect of bisphosphonate on hip fracture in patients with osteoporosis or osteopenia according to age: a meta-analysis and systematic review
Sichun Zhao, Wen Zhao, Dongpeng Du, Chunhao Zhang, Tao Zhao, Liwen Zheng, Leiming Jin, Minghao Gu, Junfeng Xu, Zhonghua Yang
Journal of Investigative Medicine Mar 2022, 70 (3) 837-843; DOI: 10.1136/jim-2021-001961
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