地诺单抗对比双膦酸盐类治疗骨质疏松有效性和安全性的Meta分析 点击下载
论文标题: 地诺单抗对比双膦酸盐类治疗骨质疏松有效性和安全性的Meta分析
英文标题:
中文摘要: 目的 系统评价地诺单抗对比双膦酸盐类治疗骨质疏松的有效性和安全性,为临床治疗提供循证参考。方法计算机检索PubMed、Embase、Medline、theCochraneLibrary、中国期刊全文数据库、中文科技期刊数据库、万方数据库,检索时限为2012年1月-2022年12月,收集地诺单抗(试验组)对比双膦酸盐类(对照组)治疗骨质疏松的随机对照试验,对纳入的临床研究进行资料提取后,采用Cochrane系统评价手册5.1.0版进行质量评价,采用RevMan5.3软件进行Meta分析。结果共纳入6项研究,共计3145例患者。Meta分析结果显示,试验组患者腰椎骨密度改善程度[MD=1.78,95%CI(1.13,2.43),P<0.00001]、股骨颈骨密度改善程度[MD=1.26,95%CI(1.08,1.45),P<0.00001]、全髋骨密度改善程度[MD=1.16,95%CI(0.93,1.39),P<0.00001]均显著优于对照组;试验组患者治疗6个月后Ⅰ型胶原C末端肽水平[MD=-0.09,95%CI(-0.16,-0.02),P=0.01]、12个月后Ⅰ型前胶原N末端肽水平[MD=-9.07,95%CI(-11.22,-6.92),P<0.001]均显著高于对照组。两组患者治疗12个月后骨折发生率[OR=1.02,95%CI(0.67,1.54),P=0.92]、不良反应发生率[OR=0.99,95%CI(0.67,1.46),P=0.97]比较,差异无统计学意义。结论地诺单抗对比双膦酸盐治疗骨质疏松在提高骨密度、改善骨代谢方面更具有优势。
英文摘要: OBJECTIVE To systematically evaluate the efficacy and safety of denosumab versus bisphosphonates in the treatment of osteoporosis, and to provide evidence-based reference for clinical treatment. METHODS Randomized controlled trials (RCTs) about denosumab (trial group) versus bisphosphonates (control group) in the treatment of osteoporosis were retrieved from PubMed, Embase, Medline, the Cochrane Library, Chinese Journal Fulltext Database, Chinese Science and Technology Journal Database, Wanfang database from January 2012 to December 2022. After the data extraction of included clinical studies, the quality of included studies was evaluated with Cochrane Handbook for Systematic Review 5.1.0, and meta-analysis was performed by using RevMan 5.3 software. RESULTS A total of 6 RCTs were included, involving 3 145 patients. Meta-analysis showed that the improvement rate of lumbar bone mineral density (BMD) [MD=1.78, 95%CI(1.13, 2.43), P<0.000 01], femoral neck BMD [MD=1.26, 95%CI (1.08, 1.45), P<0.000 01] and total hip BMD [MD=1.16,95%CI(0.93,1.39),P<0.000 01] in trial group were significantly better than control group. C-terminal telopeptide of type Ⅰ collagen after 6 months [MD=-0.09, 95%CI (-0.16, -0.02), P=0.01] and N-terminal propeptide of type Ⅰ collagen after 12 months [MD=-9.07, 95%CI (-11.22, -6.92), P< 0.001] in trial group were significantly higher than control group. There was no statistical difference in the fracture incidence rate after 12 months [OR=1.02, 95%CI (0.67,1.54), P=0.92] and the incidence of adverse reaction [OR=0.99, 95%CI (0.67,1.46), P=0.97] between 2 groups. CONCLUSIONS Denosumab has more advantages in improving BMD and bone metabolism, compared with bisphosphonates.
期刊: 2023年第34卷第11期
作者: 詹和道;姚江凌;崔红旺
英文作者: ZHAN Hedao,YAO Jiangling,CUI Hongwang
关键字: 骨质疏松;地诺单抗;双膦酸盐;骨密度;骨代谢;Meta分析
KEYWORDS: osteoporosis; dinomumab; bisphosphonates; bone mineral density; bone metabolism; meta-analysis
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