Systematic review and meta analisys of the effective use of alendronate, in control of osteoporosis in adult patients with spinal cord injury
Keywords:
spinal cord injury, osteoporosis, alendronate, bone density.Abstract
Justification: It is estimated that the annual incidence of spinal cord injury cases is about 40 per million population in the U.S., with consequent early alteration in bone microarchitecture in sublessional areas and that the fracture risk increases 2% each year, with a prevalence of fractures estimated at 34%. Is not much consensus on the pharmacological management of osteoporosis in the literature, it has been decided to conduct a systematic review of the use of alendronate in adult patients with spinal cord injury (SCI).
Objective: To conduct a systematic review and meta-analysis of alendronate studies in order to determine the efficacy and safety of pharmacological therapy on the progression of osteoporosis in adult patients with SCI compared with standard therapy.
Method: A research was done on randomized controlled trials, using terms such as “spinal cord injury, alendronate, bone loss, bone mineral density, osteoporosis, DEXA”. The intervention with alendronate and calcium was evaluated in a total of 3 articles. By statistical analysis performed with the Biostat Comprehensive MetaAnalysis 2.0. The control and experimental group were taken in order to evaluate the T-Score for lumbar spine and lower limbs at the beginning of the treatment and then after 6 months, to obtain the differences of the variables.
Conclusion: The high heterogeneity of the items does not allow a combination thereof. Alendronate therapy is effective and safe in reducing loss of BMD and this effect was maintained for 6 months after stopping treatment. The routinely use of calcium as monotherapy in patients with SCI is not effective in terms of reduction or prevention of osteoporosis.
Author Biographies
Andrés Zamora Lara, Universidad de La Sabana.
Universidad de La Sabana.
Catalina Gómez, Universidad de La Sabana.
Coordinadora del posgrado Medicina Física y Rehabilitación,
Universidad de La Sabana.
Henry Oliveros, Universidad de La Sabana.
y Cuidado Intensivo. Magíster en Epidemiología. Docente de la Universidad de La Sabana.
References
2. Eser Prisca., Frotzler Angela., Zehnder Yvonne., Denoth Jachen., Fracture threshold in the femur and tibia of people with spinal cord injury as determined by peripheral
quantitative computed tomography. Arch phys med rehabil 2005;86:498-504. 152 Andrés Zamora Lara, Catalina Gómez, Henry Oliveros Rev Col Med Fis Rehab
3. Sheng-Dan Jiang., Lei-Sheng Jiang., and Li-Yang Dai., Mechanisms of osteoporosis in spinal cord injury. Osteoporos int. 2006; 17: 180-192.
4. Maimoun L., C. Fatall., J-P. Micallef., E. Peruchon., and P. Rabischong., Bone loss in spinal cord-injured patients: from
physiopathology to therapy. Spinal cord 2006;44:203-210.
5. Zehnder Yvonne., Risi Simone., Dieter Michel, Knecht Hans, Perrelet Romain, Kraenzlin Marius, Zach Guido and
Lippuner Kurt, Prevention of bone loss in paraplegics over 2 years with alendronate, Journal of bone and mineral research, marzo 2004;19(6).
6. Bittar C., Cliquet A., Dos Santos A., Utility of quantitative ultrasound of the calcaneus in diagnosing osteoporosis in spinal cord injury patients. American Journal of Physical Medicine and Rehabilitation, june 2011; 90(6).
7. Lentle Brian., Cheung Angela M., Hanley David A., Leslie William D., Iyons David., Papaioannou Alexandra and Cols.,
Osteoporosis Canada 2010 guidelines for the assessment of fracture risk. Canadian Association of Radiologists Journal 62, 2011;243-250.
8. Phaner, V; Charmetant, C; Condemine, A; Fayolle-minon, I; Lafage-proust, m-h mh. osteoporosis in spinal cord injury. screening and treatment. results of a survey
of physical medicine and rehabilitation physician practices in france. proposals for action to be taken towards the screening and the treatment]. Annals of Physical and Rehabilitation Medicine 53, december 2010;615-620.
9. Gilchrist, N. L., Frampton C. M., Acland R. H., Nicholls M. G., March, R. L. Alendronate prevents bone loss in patients with acute spinal cord injury: a randomized, double-blind, placebo-controlled study. The Journal of Clinical Endocrinology & Metabolism. Abril 2007.
10. Moran de Brito., Ir Battistella., et Saito and h Sakamoto., Effect of alendronate on bone mineral density in spinal cord injury patients: a pilot study. Spinal Cord 2005; 43:341-348.
11. HYPERLINK «http://www.courses. washing ton.edu/bonephys/opbmdtz.html» www. courses.washington.edu/bonephys/
opbmdtz.html
How to Cite
Downloads
Downloads
Published
Issue
Section
