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
Daniel Enrique Suárez Acevedo, Universidad de los Andes.
Andrés Camilo Cardozo Alarcón, Universidad de los Andes.
References
2. Derechos Humanos y Salud: Personas con Discapacidad Mental. Página web de OPS [Internet]. 2008. Disponible en: http://www. p a h o . o r g / s p a n i s h / d d / p u b /
10069_Discap_mental.pdf. Consultado 2012/09/09
3. The Global Burden of Disease: 2004 Update. Página web de WHO - Health Statistics and Health Information Systems [Internet]. 2008. Disponible en: http://www.who.int/healthinfo/global_burden_disease/
GBD_report_2004update_full.pdf. Consultado
2012/09/09.
4. Declaración Universal de Derechos Humanos. 1948. http://www.un.org/es/documents/udhr/ Consultado 2012/09/09.
5. Pacto Internacional de Derechos Civiles y Políticos.
1966. Página web de Oficina del Alto Comisionado de las Naciones Unidas para los Derechos Humanos.http://www2.
ohchr.org/spanish/law/ccpr.htm Consultado2012/09/09.
6. Pacto Internacional de Derechos Económicos, Sociales y Culturales. 1966. Página web de Oficina del Alto Comisionado de las Naciones Unidas para los Derechos Humanos.http://www2.ohchr.org/spanish/law/cescr.htm. Consultado 2012/09/09.
7. Rubio LLorente F. El núcleo duro de los Derechos Humanos desde la perspectiva constitucional. En: BOSCH JM, editor. El núcleo duro de los Derechos Humanos: Navarra;2001.
8. Discapacidad. Página web del DANE [Internet]. 2004 julio. Disponible en: http://www.dane.gov.co/filesinvestigaciones/discapacidad/inform_estad.pdf. Consultado2012/09/01.
9. International Classification of Functioning, Disability and Health (ICF). 2001. http://www.who.int/classifications/icf/whasp.pdf. Consultado 2012/09/07.
10. Clasificación Internacional del Funcionamiento,
de la Discapacidad y de la Salud: Versión Abreviada:
Ministerio de Trabajo y Asuntos Sociales. Secretaría de Estado de Servicios Sociales, Familias y Discapacidad. Instituto de Mayores y Servicios Sociales (IMSERSO);
2001 http://www.imserso mayores.csic.es/documentos/documentos/oms-clasificacion-02.pdf. Consultada 2012/09/07.
11. Observación General 14: El derecho al disfrute del más alto nivel posible de salud. 2000, agosto 11. Página web de Oficina del Alto Comisionado de las Naciones Unidas para los Derechos Humanos [Internet]. available from: http://www2.ohchr.org/english/bodies/cescrcomments.htm. Consultado2012/09/01.
12. Ley 1306 de 2009. Página web de la Secretaría del Senado de la República de Colombia. http://www.secretariasenado.gov.co/senado/basedoc/ley/2009/ley_1306_2009.htmlConsultado 2012/09/08.
13. Protección constitucional y derechos fundamentales
de las personas con discapacidad. Página web de Defensoría del Pueblo, Colombia [Internet]. 2003-2006. Disponible en http://www.defensoria.org.co/?_s=ojc&_a=5
&_es. Consultado 2012/09/05.
14. Cruess RL. Teaching medical professionalism. Cruess RL, Cruess SR, Steinert Y, editors. New York, United States of America:Cambridge University Press; 2009.
15. Ainsworth MA, Szauter KM. Medical student professionalism: are we measuring the right behaviors? A comparison of professional lapses by students and physicians. Academic Medicine. 2006;81 (Suppl 10):S83-6.
16. Swick HM. Viewpoint: professionalism and humanism beyond the academic health center. Academic Medicine. 2007;82(11):1022-8.
17. Patiño JF. El profesionalismo médico. Revista Colombiana de Cirugía. 2004;19(3):146-52.
18. Stern DT. Measuring medical professionalism
STERN DT, editor. New York, United States of America: Oxford University Press; 2006.
19. Bishop JP, Rees CE. Hero or has-been: is there a future for altruism in medical education? Advances in Health Sciences Education: Theory and Practice. 2007;12(3):
391-9.
How to Cite
Downloads
Downloads
Published
Issue
Section
