Table 1.
Treatment effects on BMD and incident vertebral fractures in GIOP
| Intervention | Comparative | Patients, n | Design | Duration | Change in BMD,% | Change in BMD,% | Vertebral fractures | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Spine | Fem neck | Placebo | Study drug | |||||||
| Placebo | Med | Placebo | Med | |||||||
| Risedronate [6] | Placebo | 224 | Prevention | 1 year | -2.8 | +0.6a | -3.1 | +0.8a | 9/52 (17.3%) | 3/53 (5.7%) |
| Risedronate [38] | Placebo | 290 | Treatment | 1 year | +0.4 | +2.9a | -0.3 | +1.8b | 9/60 (15%) | 3/60 (5%) |
| Risedronatec [41] | Placebo | 518 | Both | 1 year | -1.0 | +1.9a | -1.5 | +1.3a | 18/111 (16.2%) | 6/111 (5.4%)b |
| Alendronate [39] | Placebo | 477 | Treatment | 1 year | -0.4 | +2.9a | -1.2 | +1.0a | 8/135 (5.9%) | 8/268 (2.9%) |
| Alendronate [5] | Placebo | 477 | Treatment | 2 years | -0.8 | +3.9a | -2.9 | +0.6b | 4/59 (6.8%) | 1/143 (0.7%)d |
| Alendronate [40] | Placebo | 173 | Treatment | 1 year | -0.6 | +2.5a | +0.1 | +0.4 | – | – |
| Zoledronic acid [7] | Risedronate | 545 | Treatment | 1 year | +2.7 | +4.1e | +1.5 | +0.4a | 5/833 (0.6%) | 3/833 (0.4%) |
| 288 | Prevention | +2.0 | +2.6e | +1.3 | -0.03a | |||||
| Ibandronate [42] | Placebo | 58 | Prevention | 1 year | -25 | 0a | -23 | 0a | (53%) | (13%)d |
| Strontium ranelate | No data | – | – | – | – | – | – | – | – | – |
| Teriparatide [44] | Alendronate | 428 | Treatment | 18 months | +3.4 | +7.2a | – | – | 10/165 (6%) | 1/171 (0.6%)f |
| Teriparatide [45••] | Alendronate | 428 | Treatment | 36 months | +5.3 | +11.0a | +3.4 | +6.3a | 13/169 (7.7%) | 3/173 (1.7%)g |
| PTH (1-84) | No data | – | – | – | – | – | – | – | – | – |
a P ≤ 0.001
b P ≤ 0.01
cCombination of 2 studies
d P = 0.02
e P ≤ 0.0001
f P = 0.004
g P = 0.007
BMD bone mineral density, Fem femoral neck, GIOP glucocorticoid-induced osteoporosis, Med medication, PTH parathyroid hormone