Bisphosphonate therapy after liver transplant improves bone mineral density and reduces fracture rates: an updated systematic review and meta‐analysis.

Autor: Ho, Owen Tsung Wen, Ng, Winston Cheng Ann, Ow, Zachariah Gene Wing, Ho, Yeung Jek, Lim, Wen Hui, Yong, Jie Ning, Wang, Renaeta Shiqi, Wong, Keng Lin, Ng, Cheng Han, Muthiah, Mark D., Teo, Claire Min‐Li
Předmět:
Zdroj: Transplant International; Aug2021, Vol. 34 Issue 8, p1386-1396, 11p
Abstrakt: Summary: To investigate the efficacy of bisphosphonates and compare oral and IV formulations on bone mineral density (BMD) and fracture incidence in post‐orthotopic liver transplant (OLT) patients. Electronic databases were searched, and six RCTs and three cohort studies were included out of 711 articles. Main outcomes included post‐OLT BMD changes, fracture incidence, and treatment adverse reactions. Pairwise meta‐analysis was conducted for binary and continuous outcomes, while pooled fracture incidence utilized single‐arm meta‐analysis. Post‐OLT fracture incidence was reported in nine studies (n = 591). Total fracture incidence was 6.6% (CI: 3.4–12.4%) in bisphosphonate group and 19.1% (CI: 14.3–25.1%) in calcium and vitamin D group. Total fractures were significantly lower in patients on bisphosphonate, compared to calcium and vitamin D (n = 591; OR = 0.037; CI: 0.18–0.77; P = 0.008). Overall fractures were significantly lower in the oral group (n = 263; OR = 0.26; CI: 0.08–0.85; P = 0.02) but not in the IV group (n = 328; OR = 0.45; CI: 0.16–1.26; P = 0.129). Both oral and IV bisphosphonates are effective in reducing fracture incidence post‐OLT compared to calcium and vitamin D. Oral formulations may also have an advantage over IV in reducing bone loss and fracture incidence post‐OLT. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index