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. 2022 Nov 2:3:845886.
doi: 10.3389/fragi.2022.845886. eCollection 2022.

Fractures reduction with osteoporotic treatments in patients over 75-year-old: A systematic review and meta-analysis

Michel Guillaumin  1 , Bastien Poirson  1 , Aurélie Gerazime  2 , Marc Puyraveau  2 , Thomas Tannou  1 , Fréderic Mauny  2 , Éric Toussirot  3   4
Affiliations

Fractures reduction with osteoporotic treatments in patients over 75-year-old: A systematic review and meta-analysis

Michel Guillaumin et al. Front Aging. .

Abstract

Background: Osteoporosis consists in the reduction of bone mineral density and increased risk of fracture. Age is a risk factor for osteoporosis. Although many treatments are available for osteoporosis, there is limited data regarding their efficacy in older people. Objective: To evaluate the efficacy of osteoporosis treatments in patients over 75 years old. Methods: We reviewed all published studies in MEDLINE, Cochrane and EMBASE including patients over 75 years old, treated by osteoporosis drugs, and focused on vertebral fractures or hip fractures. Results: We identified 4,393 records for review; 4,216 were excluded after title/abstract review. After full text review, 19 records were included in the systematic review. Most studies showed a reduction in vertebral fracture with osteoporosis treatments, but non-significant results were observed for hip fractures. Meta-analysis of 10 studies showed that lack of treatment was significantly associated with an increased risk of vertebral fractures at one (OR = 3.67; 95%CI = 2.50-5.38) and 3 years (OR = 2.19; 95%CI = 1.44-3.34), and for hip fractures at one (OR = 2.14; 95%CI = 1.09-4.22) and 3 years (OR = 1.31, 95%CI = 1.12-1.53). Conclusion: A reduction in the risk of vertebral fractures with osteoporosis treatments was observed in most of the studies included and meta-analysis showed that lack of treatment was significantly associated with an increased risk of vertebral fractures. Concerning hip fractures, majority of included studies did not show a significant reduction in the occurrence of hip fractures with osteoporotic treatments, but meta-analysis showed an increased risk of hip fractures without osteoporotic treatment. However, most of the data derived from post hoc and preplanned analyses or observational studies.

Keywords: fractures; older people; osteoporosis; osteoporosis treatments; systematic review.

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Figures

FIGURE 1
FIGURE 1
PRISMA flow chart.
FIGURE 2
FIGURE 2
Risk of bias summary.
FIGURE 3
FIGURE 3
Meta-analysis of vertebral fractures.
FIGURE 4
FIGURE 4
Meta-analysis of hip fractures.
See this image and copyright information in PMC

References

    1. Axelsson K. F., Wallander M., Johansson H., LunDh D., LorentzonM. (2017). Hip fracture risk and safety with alendronate treatment in the oldest-old. J. Intern. Med. 282, 546–559. 10.1111/joim.12678 - DOI - PubMed
    1. Bawa H. S., Weick J., Dirschl D. R. (2015). Anti-osteoporotic therapy after fragility fracture lowers rate of subsequent fracture: Analysis of a large population sample. J. Bone Jt. Surg. Am. 97, 1555–1562. 10.2106/JBJS.N.01275 - DOI - PubMed
    1. Bergman J., Nordström A., Nordström P., Nordstrom A. (2018). Bisphosphonate use after clinical fracture and risk of new fracture. Osteoporos. Int. 29, 937–945. 10.1007/s00198-017-4367-7 - DOI - PMC - PubMed
    1. Bischoff-Ferrari H. A., Willett W. C., Orav E. J., Oray E. J., Lips P., Meunier P. J., et al. (2012). A pooled analysis of vitamin D dose requirements for fracture prevention. N. Engl. J. Med. 367, 40–49. 10.1056/NEJMoa1109617 - DOI - PubMed
    1. Black D. M., Cummings S. R., Karpf D. B., Cauley J. A., Thompson D. E., Nevitt M. C., et al. (1996). Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348, 1535–1541. 10.1016/s0140-6736(96)07088-2 - DOI - PubMed

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