Bone mineral density; Fractures; Men; Osteoporosis; Bone Density Conservation Agents; Diphosphonates; Male; Female; Humans; Bone Density; Diphosphonates/therapeutic use; Bone Density Conservation Agents/therapeutic use; Osteoporosis/drug therapy; Fractures, Bone; Aging; Geriatrics and Gerontology
Abstract :
[en] [en] INTRODUCTION: The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis.
METHODS: Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI).
RESULTS: From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures.
CONCLUSIONS: Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
Disciplines :
General & internal medicine Public health, health care sciences & services
Author, co-author :
Beaudart, Charlotte ; WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
Demonceau, Céline ; WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
Sabico, Shaun; Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451, Saudi Arabia
Veronese, Nicola; Geriatric Unit, Department of Internal Medicine, Geriatrics Section, University of Palermo, via del Vespro, 141, 90127, Palermo, Italy
Cooper, Cyrus; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
Harvey, Nicholas; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
Fuggle, Nicholas; MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
Bruyère, Olivier ; WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
Rizzoli, René; Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Hopitaux Universitaires Geneve, Geneva, Switzerland. Rene.Rizzoli@unige.ch
Reginster, Jean-Yves ; WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000, Liège, Belgium
Language :
English
Title :
Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis.
Publication date :
September 2023
Journal title :
Aging Clinical and Experimental Research
ISSN :
1594-0667
eISSN :
1720-8319
Publisher :
Springer Science and Business Media Deutschland GmbH, Germany
ESCEO - European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases [BE] UNIGE - University of Geneva [CH]
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