Bisphosphonates for the prevention of osteoporosis in patients treated with systematic corticosteroids

Pamidronate (administered as an IV infusion) and clondronate (administered orally or IV) are also bisphosphonates available in Canada but are not specifically approved for use in the prevention of corticosteroid induced osteoporosis.6-8 This report will review the evidence regarding the use of bisphosphonates for the prevention of osteoporosis in patients treated with systemic corticosteroids and [...] Bisphosphonates for the Prevention of Osteoporosis in Patients Treated with Systematic Corticosteroids 2 Critical Appraisal of Individual Studies The quality of the included systematic reviews was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool.9 The adequacy of randomization, allocation concealment, blinding of patients, clinicians or health care providers, data collect [...] The study selection process is outlined in a PRISMA flowchart in Appendix 1. Summary of Study Characteristics Systematic Reviews The characteristics of the included systematic reviews are summarized in Appendix 2. The populations of interest in the four systematic reviews10-12,20 included any patients on corticosteroids (i.e, treatment or prevention populations); however, results were presented fo [...] Summary of Findings Clinical evidence on the use of bisphosphonates for the prevention of osteoporosis in patients treated with systemic corticosteroids Vertebral and Non-vertebral Fractures In separate systematic reviews, the reduction in relative risk (RR) of vertebral20 and non- vertebral12 fractures with etidronate was not statistically significant. [...] In this systematic review, the change in BMD in the lumbar spine was statistically significant but not statistically significant in the femoral neck in five studies.