Relationship Between Change in Bone Mineral Density of Lumbar Spine and Risk of New Vertebral and Nonvertebral Fractures: A Meta-Analysis

Overview

Journal Orthop Surg

Specialty Orthopedics

Date 2022 Jan 5

PMID 34985187

Citations 1

Authors

Liang Chen

Xiao-Ping Liu

Bo Zhou

Tong-Ya Guo

Feng Yuan

Mohamed E A Abdelrahim

Zhen-Huan Jiang

Affiliations

Soon will be listed here.

Abstract

Studies have shown that the change in lumbar spine bone mineral density with different osteoporosis drugs had a beneficial effect on the frequency of new vertebral and nonvertebral fractures in postmenopausal females, but their results were conflicting. This meta-analysis was performed to evaluate this relationship. A systematic literature search up to May 2020 was performed and 20 studies with 73,390 postmenopausal females were included; of them, a total of 41,980 were treated with osteoporosis drugs and 31,410 with placebo. They reported relationships between the change in lumbar spine bone mineral density and the frequency of new vertebral and nonvertebral fractures in postmenopausal females. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated comparing the osteoporosis drugs to placebo effect on the frequency of new vertebral and nonvertebral fractures in postmenopausal females using the dichotomous method with a random or fixed-effect model. Treatment with osteoporosis drugs had significantly lower frequency of new vertebral fractures (OR, 0.53; 95% CI, 0.45-0.63, P < 0.001) and nonvertebral fractures (OR, 0.82; 95% CI, 0.78-0.87, P < 0.001) compared to placebo in postmenopausal females. Treatment with osteoporosis drugs had a significantly lower frequency of new vertebral and nonvertebral fractures compared to placebo in postmenopausal females. This relationship forces us to recommend osteoporosis drugs in postmenopausal females to avoid any possible new fractures. A cost-effective study is recommended.

Citing Articles

Attributable disease burden related to low bone mineral density in Iran from 1990 to 2019: results from the Global Burden of Disease 2019.

Azangou-Khyavy M, Moghaddam S, Mohammadi E, Shobeiri P, Rashidi M, Ahmadi N Arch Osteoporos. 2022; 17(1):140.

PMID: 36355233 DOI: 10.1007/s11657-022-01180-z.

References

Cummings S, McClung M, Reginster J, Cox D, Mitlak B, Stock J . Arzoxifene for prevention of fractures and invasive breast cancer in postmenopausal women. J Bone Miner Res. 2010; 26(2):397-404. DOI: 10.1002/jbmr.191. View

Hochberg M, Ross P, Black D, Cummings S, Genant H, Nevitt M . Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis. Fracture Intervention Trial Research Group. Arthritis Rheum. 1999; 42(6):1246-54. DOI: 10.1002/1529-0131(199906)42:6<1246::AID-ANR22>3.0.CO;2-U. View

Krueger D . ISCD in 2015: State of the Society. J Clin Densitom. 2015; 18(3):445-6. DOI: 10.1016/j.jocd.2015.06.004. View

Pouilles J, Tremollieres F, LOUVET J, Fournie B, Morlock G, Ribot C . Sensitivity of dual-photon absorptiometry in spinal osteoporosis. Calcif Tissue Int. 1988; 43(6):329-34. DOI: 10.1007/BF02553274. View

Cummings S, San Martin J, McClung M, Siris E, Eastell R, Reid I . Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009; 361(8):756-65. DOI: 10.1056/NEJMoa0809493. View

Kanis J, Johnell O, De Laet C, Johansson H, Oden A, Delmas P . A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004; 35(2):375-82. DOI: 10.1016/j.bone.2004.03.024. View

Sheikhbahaei S, Trahan T, Xiao J, Taghipour M, Mena E, Connolly R . FDG-PET/CT and MRI for Evaluation of Pathologic Response to Neoadjuvant Chemotherapy in Patients With Breast Cancer: A Meta-Analysis of Diagnostic Accuracy Studies. Oncologist. 2016; 21(8):931-9. PMC: 4978549. DOI: 10.1634/theoncologist.2015-0353. View

Harris S, Watts N, Jackson R, Genant H, Wasnich R, Ross P . Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis: three years of blinded therapy followed by one year of open therapy. Am J Med. 1993; 95(6):557-67. DOI: 10.1016/0002-9343(93)90350-x. View

Jacques R, Boonen S, Cosman F, Reid I, Bauer D, Black D . Relationship of changes in total hip bone mineral density to vertebral and nonvertebral fracture risk in women with postmenopausal osteoporosis treated with once-yearly zoledronic acid 5 mg: the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res. 2012; 27(8):1627-34. DOI: 10.1002/jbmr.1644. View

10.

Black D, Cummings S, Karpf D, Cauley J, Thompson D, Nevitt M . Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996; 348(9041):1535-41. DOI: 10.1016/s0140-6736(96)07088-2. View

11.

Moustafa I, Ali M, Al Hallag M, Rabea H, Fink J, Dailey P . Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients. Heart Lung. 2017; 46(6):464-467. DOI: 10.1016/j.hrtlng.2017.08.004. View

12.

Recker R, Stakkestad J, Chesnut 3rd C, Christiansen C, Skag A, Hoiseth A . Insufficiently dosed intravenous ibandronate injections are associated with suboptimal antifracture efficacy in postmenopausal osteoporosis. Bone. 2004; 34(5):890-9. DOI: 10.1016/j.bone.2004.01.008. View

13.

Ettinger B, Black D, Mitlak B, Knickerbocker R, Nickelsen T, Genant H . Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999; 282(7):637-45. DOI: 10.1001/jama.282.7.637. View

14.

Gupta A, Das A, Majumder K, Arora N, Mayo H, Singh P . Obesity is Independently Associated With Increased Risk of Hepatocellular Cancer-related Mortality: A Systematic Review and Meta-Analysis. Am J Clin Oncol. 2017; 41(9):874-881. PMC: 5700876. DOI: 10.1097/COC.0000000000000388. View

15.

Cummings S, Ensrud K, Delmas P, LaCroix A, Vukicevic S, Reid D . Lasofoxifene in postmenopausal women with osteoporosis. N Engl J Med. 2010; 362(8):686-96. DOI: 10.1056/NEJMoa0808692. View

16.

Meunier P, Roux C, Seeman E, Ortolani S, Badurski J, Spector T . The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004; 350(5):459-68. DOI: 10.1056/NEJMoa022436. View

17.

Bruyere O, Roux C, Detilleux J, Slosman D, Spector T, Fardellone P . Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate. J Clin Endocrinol Metab. 2007; 92(8):3076-81. DOI: 10.1210/jc.2006-2758. View

18.

Black D, Delmas P, Eastell R, Reid I, Boonen S, Cauley J . Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007; 356(18):1809-22. DOI: 10.1056/NEJMoa067312. View

19.

Chesnut 3rd C, Silverman S, Andriano K, Genant H, Gimona A, Harris S . A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study. PROOF Study Group. Am J Med. 2000; 109(4):267-76. DOI: 10.1016/s0002-9343(00)00490-3. View

20.

Chesnut 3rd C, Skag A, Christiansen C, Recker R, Stakkestad J, Hoiseth A . Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004; 19(8):1241-9. DOI: 10.1359/JBMR.040325. View