Efficacy of bisphosphonates against osteoporosis in adult men: a meta-analysis of randomized controlled trials

Chen, L.; Wang, Guiquan; Fan, Zheng; Zhao, Hao; Li, H.

doi:10.1007/s00198-015-3148-4

Cited by 21 publications

(12 citation statements)

References 33 publications

(66 reference statements)

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“…However, we extend this observation by also reporting a significant association between lower testosterone levels and higher BAP levels, primarily in men younger than 56 years of age. BAP is a marker of bone metabolism, and elevated levels in men have been associated with osteoporosis [22,23]. Reduced estradiol concentrations have important clinical implications, given the critical role of estradiol on bone density, body composition, and sexual function in men [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Association of low testosterone with changes in non-cardiovascular biomarkers in adult men

Samoszuk¹,

Morgentaler

Groot

et al. 2019

Int J Impot Res

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Testosterone has effects on many organs and systems. The purpose of this study was to test the hypothesis that low testosterone is associated with changes in various non-cardiovascular biomarkers in men older than 40 who were tested for possible hypogonadism. We extracted data from 9939 outpatient men who were over 40 years old (median age 56) and who also had concurrent laboratory measurements of total testosterone and one or more biomarkers of interest: estradiol, uric acid, prostate-specific antigen (PSA), sex-hormone binding globulin (SHBG), luteinizing hormone, creatinine, bone alkaline phosphatase (BAP), creatine kinase, hemoglobin A1c, and 25-hydroxy-vitamin D, and body mass index (BMI). In a smaller exploratory study of 19 otherwise healthy men presenting for evaluation of possible hypogonadism, pre-albumin (a.k.a. transthyretin, a marker of anabolism) and testosterone were measured. Men with lower levels of testosterone had significantly (p < 0.001) lower mean levels of PSA, SHBG, luteinizing hormone, and estradiol. Overall, men with low levels of testosterone also had significantly (p < 0.001) higher mean levels of LDH and BAP, but these associations varied between men who were younger or older than 56 years. There was a moderate but statistically significant positive correlation (r = 0.63, p < 0.05) between testosterone levels and pre-albumin. These results confirm our hypothesis that testosterone deficiency is associated with a broad range of systemic changes demonstrable in hormonal and non-hormonal serum assays in men over 40 years old being tested for possible hypogonadism.

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Section: Discussionmentioning

confidence: 99%

Association of low testosterone with changes in non-cardiovascular biomarkers in adult men

Samoszuk¹,

Morgentaler

Groot

et al. 2019

Int J Impot Res

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“…Fracture risk was similar between treatment group (adjusted HR = 1.0 [95% CI 0.53-1.90]). However, there was an interaction between treatment and baseline femoral neck BMD, and a subgroup analysis of individuals with a T-score ≤ -2.5 SD revealed a [11][12][13][14][15][16][17][18][19][20][21][22]; p = 0.03 ( Table 2, Fig. 3).…”

Section: Nitrogen Bisphosphonates Versus Matched Nontreatmentmentioning

confidence: 99%

“…Bisphosphonates are currently considered first‐line treatment for osteoporosis worldwide with abundant evidence of their ability to reduce both vertebral and nonvertebral fracture risk . More recently, bisphosphonates have been also linked to improved survival .…”

Section: Introductionmentioning

confidence: 99%

“…(6)(7)(8)(9) Bisphosphonates are currently considered first-line treatment for osteoporosis worldwide (10,11) with abundant evidence of their ability to reduce both vertebral and nonvertebral fracture risk. (12)(13)(14) More recently, bisphosphonates have been also linked to improved survival. (15,16) The first evidence of a positive association between bisphosphonate use and survival came from a randomized control trial (RCT) of zoledronic acid post-hip fracture.…”

Section: Introductionmentioning

confidence: 99%

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Reduced Bone Loss Is Associated With Reduced Mortality Risk in Subjects Exposed to Nitrogen Bisphosphonates: A Mediation Analysis

Bliuc

Tran

Geel

et al. 2019

Journal of Bone and Mineral Research

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Bisphosphonates, potent antiresorptive agents, have been found to be associated with mortality reduction. Accelerated bone loss is, in itself, an independent predictor of mortality risk, but the relationship between bisphosphonates, bone loss, and mortality is unknown. This study aimed to determine whether the association between bisphosphonates and mortality is mediated by a reduction in the rate of bone loss. Participants from the population‐based Canadian Multicentre Osteoporosis Study were followed prospectively between1996 and 2011. Comorbidities and lifestyle factors were collected at baseline and bone mineral density (BMD) at baseline and at years 3 (for those aged 40 to 60 years), 5, and 10. Rate of bone loss was calculated using linear regression. Information on medication use was obtained yearly. Bisphosphonate users grouped into nitrogen bisphosphonates (nBP; alendronate or risedronate) and etidronate and non‐users (NoRx) were matched by propensity score, including all baseline factors as well as time of treatment. Cox's proportional hazards models, unadjusted and adjusted for annual rate of bone loss, were used to determine the association between nBP and etidronate versus NoRx. For the treatment groups with significant mortality risk reduction, the percent of mortality reduction mediated by a reduction in the rate of bone loss was estimated using a causal mediation analysis. There were 271 pairs of nBP and matched NoRx and 327 pairs of etidronate and matched NoRx. nBP but not etidronate use was associated with significant mortality risk reduction (hazard ratios [HR] = 0.61 [95% confidence interval 0.39–0.96] and 1.35 [95% CI 0.86–2.11] for nBP and etidronate, respectively). Rapid bone loss was associated with more than 2‐fold increased mortality risk compared with no loss. Mediation analysis indicated that 39% (95% CI 7%–84%) of the nBP association with mortality was related to a reduction in the rate of bone loss. This finding provides an insight into the mechanism of the relationship between nBP and survival benefit in osteoporotic patients. © 2019 American Society for Bone and Mineral Research.

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“…DXA is cost-effective in both fracture risk prediction with or without implementing the FRAX-calculator, and in universal prevention strategies [12][13][14][15]. Most of the drugs used in the treatment of postmenopausal osteoporosis have proven effi cacious and cost-effective in men also [16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Patterns in the Diagnosis and Treatment of Osteoporosis in Men: A Questionnaire-based Survey in Central and Eastern European Countries

Boyanov

Czerwiński

Shinkov

et al. 2017

Acta Medica Bulgarica

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Efficacy of bisphosphonates against osteoporosis in adult men: a meta-analysis of randomized controlled trials

Abstract: Compared with placebo, bisphosphonates could decrease the risk of vertebral and non-vertebral fractures, reduce BSAP and CTX, and increase BMD in men with osteoporosis.

Cited by 21 publications

References 33 publications

Association of low testosterone with changes in non-cardiovascular biomarkers in adult men

Association of low testosterone with changes in non-cardiovascular biomarkers in adult men

Reduced Bone Loss Is Associated With Reduced Mortality Risk in Subjects Exposed to Nitrogen Bisphosphonates: A Mediation Analysis

Patterns in the Diagnosis and Treatment of Osteoporosis in Men: A Questionnaire-based Survey in Central and Eastern European Countries

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