Τίτλος:
Efficacy of anti-osteoporotic medications in patients with type 1 and 2 diabetes mellitus: a systematic review
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: Both type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have been associated with bone fragility and increased fracture risk. However, little is known regarding the effect of anti-osteoporotic treatment on bone mineral density (BMD) and/or fracture risk in these patients. We aimed to systematically investigate the efficacy of anti-osteoporotic medications in patients with diabetes in comparison with non-diabetic subjects. Methods: MEDLINE and Scopus databases were searched (up to 31st October 2017). Results: Nine studies fulfilled the pre-defined inclusion criteria [patients with T2DM (n = 8) or either T1DM or T2DM (n = 1)]. Regarding fracture risk, five studies were identified. Alendronate demonstrated comparable vertebral anti-fracture efficacy in patients with and without diabetes (n = 2), whereas non-vertebral fracture risk was either the same (n = 1) or higher in diabetic patients (n = 1). Raloxifene also demonstrated comparable vertebral anti-fracture efficacy in both groups (n = 2), without any effect on non-vertebral fractures in either group. In one study, diabetic patients exposed to raloxifene demonstrated the same vertebral and non-vertebral fracture risk with non-diabetic patients. Teriparatide (n = 1) demonstrated the same non-vertebral fracture rates in both patients with and without T2DM. Regarding BMD, equal increases in spine BMD were observed with alendronate (n = 4), risedronate (n = 1), and teriparatide (n = 1). With respect to hip BMD, similar increases were observed with teriparatide (n = 1), whereas data regarding alendronate were controversial (n = 3). No eligible study was found for zoledronic acid, ibandronate, strontium ranelate, denosumab, or bazedoxifene. Conclusions: The presence of diabetes does not alter anti-osteoporotic treatment response, regarding BMD increase and vertebral fracture risk reduction. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Anagnostis, P.
Paschou, S.A.
Gkekas, N.N.
Artzouchaltzi, A.-M.
Christou, K.
Stogiannou, D.
Vryonidou, A.
Potoupnis, M.
Goulis, D.G.
Περιοδικό:
Endocrine Development
Εκδότης:
Humana Press Inc.
Λέξεις-κλειδιά:
alendronic acid; alkaline phosphatase bone isoenzyme; anti osteoporotic agent; biological marker; hormone; parathyroid hormone[1-34]; raloxifene; unclassified drug; bone density conservation agent, bone density; bone fragility; bone turnover; drug effect; drug efficacy; drug response; fracture; human; insulin dependent diabetes mellitus; non insulin dependent diabetes mellitus; ossification; osteoporosis; priority journal; Review; risk factor; risk reduction; systematic review; complication; drug effect; insulin dependent diabetes mellitus; non insulin dependent diabetes mellitus; osteoporosis, Bone Density; Bone Density Conservation Agents; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Osteoporosis
DOI:
10.1007/s12020-018-1548-x
