Περίληψη:
Vertebral collapse is one of the most common fractures associated with
osteoporosis. The subsequent back pain is severe and often requires
medications, bed rest and hospitalization to control pain and improve
mobilization. The purpose of this systematic review was to assess the
effects of calcitonin versus placebo for the treatment of acute pain in
patients sustaining stable, recent, osteoporotic vertebral compression
fractures. MEDLINE (1966-2003), EMBASE (1980-2003), Cochrane Controlled
Trial Registry (2003, volume 3), other databases, and conference
proceedings were searched for relevant research. Primary study authors
and the pharmaceutical manufacturer were contacted, and bibliographies
of relevant papers were hand-searched. Randomized, double-blind,
placebo-controlled trials comparing calcitonin versus placebo for the
acute pain of recent osteoporotic vertebral compression fractures were
included. Two reviewers extracted data, performed numeric calculations
and extrapolated graphical data independently. The combined results from
five randomized controlled trials, involving 246 patients, determined
that calcitonin significantly reduced the severity of pain using a
visual analogue scale following diagnosis. Pain at rest was reduced as
early as 1 week into treatment (weighted mean difference [WMD] =3.08;
95% confidence interval [CI]: 2.64, 3.52) and this effect continued
weekly to 4 weeks (WMD =4.03; 95% CI: 3.70, 4.35). A similar pattern
was seen for pain scores associated with sitting, standing, and walking.
Side effects were gastrointestinal, minor and often self-limited.
Calcitonin appears to be effective in the management of acute pain
associated with acute osteoporotic vertebral compression fractures by
shortening time to mobilization.
Συγγραφείς:
Knopp, JA
Diner, BM
Blitz, M
Lyritis, GP
Rowe, BH
