Efficacy and safety of zoledronic acid in the treatment of osteoporosis: A meta-analysis of randomized controlled trials
Jianfeng Sun,
Masoud Rahmati,
Wenqing Xie,
Guang Yang,
Bingzhou Ji,
Dong Keon Yon,
Seung Won Lee,
Razak M. Gyasi,
Guillermo F. López Sánchez,
Pinar Soysal,
Ai Koyanagi,
Lee Smith,
Jae Il Shin,
Yusheng Li
Affiliations
Jianfeng Sun
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China
Masoud Rahmati
Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Wenqing Xie
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China
Guang Yang
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
Bingzhou Ji
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
Dong Keon Yon
Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
Seung Won Lee
Department of Precision Medicine, Sungkyunkwan University College of Medicine, Suwon, Republic of Korea
Razak M. Gyasi
African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
Guillermo F. López Sánchez
Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
Pinar Soysal
Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
Ai Koyanagi
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, 28029 Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, 08010 Barcelona, Spain
Lee Smith
Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Jae Il Shin
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
Yusheng Li
Deparment of Orthopedics, Xiangya Hospital, Central South University, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Corresponding author. Department of Orthopedics, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.
Purpose: Zoledronic acid can inhibit the activity of osteoclasts, and thus, may slow or inhibit bone loss. The purpose of this study was to systematically evaluate the efficacy and safety of zoledronic acid in the treatment of osteoporosis. Methods: Four databases, PubMed, Embase, Cochrane Library, and Web of Science, were systematically searched up to December 26, 2022. The primary outcomes included bone mineral density (BMD), carboxy-terminal cross-linked telopeptide of type 1 collagen (CTX), bone-specific alkaline phosphatase (BSAP), procollagen type 1 N-terminal prope-ptide (P1NP), adverse events, and fracture. Secondary outcomes included serum sclerostin level, Visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI). Results: A total of 22 randomized controlled trials were included in this meta-analysis. Meta-analysis results showed that zoledronic acid was effective in increasing BMD of the lumbar spine, femoral neck, trochanter and serum sclerostin level; and reduced CTX, BSAP, P1NP, VAS score, and ODI in patients with osteoporosis. Regarding safety, zoledronic acid could reduce the incidence of fractures but had relatively more adverse events. Conclusion: Zoledronic acid can significantly improve BMD of the lumbar spine, femoral neck and trochanter, and effectively reduce incidence of fracture in patients with osteoporosis, thereby significantly improving patients' quality of life. However, the incidence of adverse events was higher than that of patients treated with placebo.
