دورية أكاديمية

The effect of teriparatide on patients with atypical femur fractures: a systematic review and meta-analysis.

التفاصيل البيبلوغرافية
العنوان: The effect of teriparatide on patients with atypical femur fractures: a systematic review and meta-analysis.
المؤلفون: Salamah, Hazem Mohamed1 (AUTHOR) hazem.salamah@gmail.com, Abualkhair, Khaled Alsayed1 (AUTHOR), Kamal, Sara K.2 (AUTHOR), Mohamed, Hazem A.1 (AUTHOR), Alkheder, Ahmad3,4 (AUTHOR), Farho, Mohamad Ali5 (AUTHOR), Mistry, Dillan6 (AUTHOR), Elbardesy, Hany7 (AUTHOR)
المصدر: Archives of Orthopaedic & Trauma Surgery. Mar2024, Vol. 144 Issue 3, p1091-1106. 16p.
مصطلحات موضوعية: *FEMORAL fractures, *TERIPARATIDE, *BONE densitometry, *BONE grafting, *CLINICAL trials, *FRACTURE healing
مستخلص: Introduction: Bisphosphonates (BPs) are one of the most often used drugs to lower fracture risk in osteoporosis patients; nonetheless, BPs have been linked to atypical femoral fracture (AFF). Teriparatide (TPTD) is a parathyroid hormone analogue and anabolic drug that may accelerate fracture repair. TPTD has been considered as a possible treatment for AFF, particularly those caused by BP use. We evaluate the effect of TPTD on AFF in this systematic review and meta-analysis. Materials and methods: A thorough search of: Web of Science, Scopus, PubMed, and Cochrane was conducted on August 2, 2023. Trials evaluating the effect of TPTD on the incidence of: complete bone healing, non-union, early and delayed bone union, progression of incomplete AFF to complete AFF, and time to bone union were included. Using Review Manager (RevMan) version 5.4, the risk ratio (RR) and mean difference (MD) with the corresponding 95% confidence interval (CI) were estimated for dichotomous and continuous outcomes, respectively. The Newcastle–Ottawa Scale was used to assess the quality of studies. Results: Eight studies met the eligibility criteria and were included in our analysis. TPTD significantly increased the incidence of early bone union (RR = 1.45, 95% CI [1.13, 1.87], P = 0.004) and time to bone union (MD = −1.56, 95% CI [−2.86, −0.26], P = 0.02) compared to the control group. No significant differences were observed in terms of complete bone healing (RR = 1.09, 95% CI [0.99, 1.13], P = 0.12), non-union (RR = 0.48, 95% CI [0.22, 1.04], P = 0.06), and progression of incomplete AFF to complete AFF (RR = 0.27, 95% CI [0.04, 1.97], P = 0.19). Conclusions: TPTD is an effective therapy for enhancing and hastening healing following AFF, particularly in postoperative settings. Future large randomized clinical trials are needed to confirm or dispute the results. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
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Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => *<searchLink fieldCode="DE" term="%22FEMORAL+fractures%22">FEMORAL fractures</searchLink><br />*<searchLink fieldCode="DE" term="%22TERIPARATIDE%22">TERIPARATIDE</searchLink><br />*<searchLink fieldCode="DE" term="%22BONE+densitometry%22">BONE densitometry</searchLink><br />*<searchLink fieldCode="DE" term="%22BONE+grafting%22">BONE grafting</searchLink><br />*<searchLink fieldCode="DE" term="%22CLINICAL+trials%22">CLINICAL trials</searchLink><br />*<searchLink fieldCode="DE" term="%22FRACTURE+healing%22">FRACTURE healing</searchLink> )
Array ( [Name] => Abstract [Label] => Abstract [Group] => Ab [Data] => Introduction: Bisphosphonates (BPs) are one of the most often used drugs to lower fracture risk in osteoporosis patients; nonetheless, BPs have been linked to atypical femoral fracture (AFF). Teriparatide (TPTD) is a parathyroid hormone analogue and anabolic drug that may accelerate fracture repair. TPTD has been considered as a possible treatment for AFF, particularly those caused by BP use. We evaluate the effect of TPTD on AFF in this systematic review and meta-analysis. Materials and methods: A thorough search of: Web of Science, Scopus, PubMed, and Cochrane was conducted on August 2, 2023. Trials evaluating the effect of TPTD on the incidence of: complete bone healing, non-union, early and delayed bone union, progression of incomplete AFF to complete AFF, and time to bone union were included. Using Review Manager (RevMan) version 5.4, the risk ratio (RR) and mean difference (MD) with the corresponding 95% confidence interval (CI) were estimated for dichotomous and continuous outcomes, respectively. The Newcastle–Ottawa Scale was used to assess the quality of studies. Results: Eight studies met the eligibility criteria and were included in our analysis. TPTD significantly increased the incidence of early bone union (RR = 1.45, 95% CI [1.13, 1.87], P = 0.004) and time to bone union (MD = −1.56, 95% CI [−2.86, −0.26], P = 0.02) compared to the control group. No significant differences were observed in terms of complete bone healing (RR = 1.09, 95% CI [0.99, 1.13], P = 0.12), non-union (RR = 0.48, 95% CI [0.22, 1.04], P = 0.06), and progression of incomplete AFF to complete AFF (RR = 0.27, 95% CI [0.04, 1.97], P = 0.19). Conclusions: TPTD is an effective therapy for enhancing and hastening healing following AFF, particularly in postoperative settings. Future large randomized clinical trials are needed to confirm or dispute the results. [ABSTRACT FROM AUTHOR] )
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