Table 1.
Study | Saag5 | Cohen6 | Reid7 | Saag8 | Reid9 | Saag26 | |||
---|---|---|---|---|---|---|---|---|---|
Study drug | Alendronate | Risedronate | Risedronate | Teriparatide | Zoledronic acid | Denosumab | |||
Comparator | Placebo | Placebo | Placebo | Alendronate | Risedronate | Risedronate | |||
Design | Treatment | Prevention | Treatment | Treatment | Prevention | Treatment | Prevention | Treatment | |
Study sites | 22 | 28 | 23 | 67 | 54 | 79 | |||
Study length (years) | 1 (+1 extension) | 1 | 1 | 1.5 (+1.5 extension) | 1 | 1 (+1 extension) | |||
Study size (patients enrolled) | 561 | 228 | 290 | 428 | 288 | 546 | 290 | 505 | |
Mean age (years) (56–69 years) | 55 | 62 | 58 | 56 | 56 | 53 | 66 | 61 | |
Postmenopausal women (%) (51–63%) | 49 | 46 | 53 | 78 | 69 | 64 | 59 | 63 | |
Premenopausal women (%) (1–2%) | 22 | 20 | 9 | 2.5 | 0.4 | 4 | 5 | 10 | |
Men (%) (35–47%) | 29 | 34 | 38 | 20 | 32 | 32 | 36 | 27 | |
Ethnicity (% white) | 88 | N/S | N/S | 72 | N/S | 84 | 90 | ||
Prednisone equivalent inclusion criteria | ⩾7.5 mg/day | ⩾7.5 mg/day | ⩾7.5 mg/day | ⩾5 mg/day | ⩾7.5 mg/day | ⩾7.5 mg/day | |||
Mean prednisone equivalent dose (mg) | Baseline | 18 | 21 | 15 | 7.5 (median) | 10 (median) | 10 (median) | 16 | 12 |
End of study | 9 | 11 | 13 | N/S | N/S | N/S | N/S | N/S | |
T-score inclusion criteria | N/A | N/A | N/A | T-score ⩽2.0 or ⩽1.0 with fracture | N/A | N/A | N/A | T-score ⩽2.0 or ⩽1.0 with fracture | |
Mean lumbar spine T-score at baseline | 1.0 (g/cm2) | –0.7 | –1.7 | –2.5 | –1.0 | –1.4 | –1.0 | –2.0 | |
Baseline osteoporosis defined by bone mineral density (%) | 32 | N/S | 23 | N/S | N/S | N/S | N/S | N/S | |
Prevalent vertebral fractures (%) | Study drug | 15 | 30 | 33 | 30 | N/S | N/S | 14 | 26 |
Comparator/placebo | 17 | 29 | 37 | 25 | N/S | N/S | 18 | 32 | |
Calcium supplementation mg/day | 800–1000 | 500 | 1000 | 1000 | 1000 | 1000 | |||
Vitamin D supplementation IU/day | 250–500 | None | 400 | 800 | 400–1200 | 800 | |||
Underlying conditions (%) | Rheumatoid arthritis (23%) | 30 | 40 | 40 | 48 | 38 | 13 | 33 | 43 |
PMR/GCA (22%/6%) | 23 | 34 | 18 | 4 | 20 | 5 | 35 | 7 | |
SLE (N/S) | 19 | 15 | 8 | 12 | 9 | 16 | 2 | 6 | |
Asthma or COPD (19%) | 10 | 4 | 20 | 13 | 4 | 8 | 2 | 11 | |
Sarcoidosis (N/S) | 3 | N/S | N/S | N/S | N/S | N/S | 0 | 2 | |
IBD (5%) | 5 | N/S | N/S | 2 | N/S | N/S | N/S | N/S | |
Neurologic diseases (6%) | 7 | 1 | 3 | N/S | N/S | N/S | 1 | 5 | |
Skin disorders (5%) | 7 | N/S | N/S | N/S | N/S | N/S | 3 | 3 |
COPD, chronic obstructive pulmonary disease; GCA, giant cell arteritis; GIOP, glucocorticoid-induced osteoporosis; IBD, inflammatory bowel diseases; N/A, not applicable; N/S, not specified; IU, international units; PMR, polymyalgia rheumatica; SLE, systemic lupus erythematosus.
Prevention design refers to participants on glucocorticoids for up to 3 months; treatment designation refers to participants on glucocorticoids for ⩾3 months. In square brackets expected characteristics for the glucocorticoid users in the general population (epidemiological data by Overman and colleagues1 and Walsh and colleagues31).