Efficacy of alendronate for the treatment of ankylosing spondylitis

Abstract

Background: Ankylosing spondylitis (AS) is a very tricky orthopedic disorder. If such condition cannot be managed fairly well, it may significantly affect quality of life and even leads to disability among such population. A variety of studies have reported that alendronate is utilized for the treatment of AS. However, their results are still contrary, and no systematic review has addressed on this topic. Thus, this study will systematically assess the efficacy and safety of alendronate for the treatment of patients with AS. Methods: A comprehensive literature search will be performed from the below electronic databases from their commencement to the January 31, 2020 without language and publication status limitations: PubMed, Embase, Cochrane Library, Web of Science, Allied and Complementary Medicine Database, WANGFANG, and China National Knowledge Infrastructure. Only randomized controlled trials focusing on the alendronate for the treatment of patients with AS will be considered for inclusion in this study. Two authors will independently select all identified records, extract essential data from all included studies, and appraise study quality for each eligible trial using Cochrane risk of bias. If any differences occur, another experienced author will be invited to solve them by discussion and a consensus decision will be made. We will implement RevMan 5.3 software to analyze the extracted data. Results: This study will summarize high-quality randomized controlled trials to assess the efficacy and safety of alendronate for the treatment of patients with AS through primary outcome of bone densitometry; and secondary outcomes of pain intensity, quality of life, disease activity, functional status, and adverse events. Conclusion: This study will provide evidence to help determine whether alendronate is an effective and safe management for patient with AS or not. Study registration: INPLASY202040153.

Efficacy and safety of Iguratimod in the treatment of Ankylosing Spondylitis: A systematic review and meta-analysis of randomized controlled trials

“…Eight RCTs (15,(17)(18)(19)(20)(21)(22)(23) utilized BASDAI to assess the improvement of AS, which include 247 patients in IGU group and 225 patients in control group. The heterogeneity test showed that P<0.00001, I2 = 86%, which suggest that the heterogeneity is high, and the random effects model was used for analysis.…”

“…Nine RCTs (15)(16)(17)(18)(19)(20)(21)(22)24) (284 patients in experimental group and 258 patients in control group) reported adverse events. The heterogeneity test P=0.37, I2 = 8%, indicating that the included studies are heterogeneous, and the fix effects model is used for analysis.…”

“…IGU not only inhibits related inflammation-related signaling pathways and the expression of inflammatory factors (NF-kB and IL-17 inflammatory signaling pathways) (12), but also inhibits osteoclast differentiation (RANKL signaling pathway), promote osteoblast function (BMP/Dlx5/Osterix signaling pathway), and reduce cartilage destruction (MMPs family related factors) (13,14), so as to play a bone protection role. At present, clinical randomized controlled trial (RCT)s showed the efficacy of IGU on AS (15)(16)(17)(18)(19)(20)(21)(22)(23)(24), but there is no relevant research to systematic review and meta-analyze these RCTs to provide new evidence. Therefore, this research will evaluate the effectiveness and safety of IGU intervention in AS through systematic reviews and meta-analysis for the first time, in order to provide new evidence for clinical use.…”