Bisphosphonates for the primary and secondary prevention of osteoporotic fractures in postmenopausal women : Méta-analyse des bisphosphonates dans la prévention primaire et la prévention secondaire des fractures ostéoporotiques après la ménopause

Michel Boucher assisted in the design of the analysis, reporting and interpretation of the findings, and was involved in the writing of the first draft of the report. [...] Comparisons of the adverse event potential of the drugs were complicated by the fact that the randomized controlled trials Bisphosphonates for the Primary and Secondary Prevention of Osteoporotic iv Fractures in Postmenopausal Women: A Meta-Analysis that formed the basis of the meta-analyses tended to enrol healthier participants, and did not consistently report or measure rare events. [...] Acknowledging the available evidence, we conclude that the main benefit of the three bisphosphonates available on the Canadian market for the management of osteoporotic fractures, is the secondary prevention of such fractures. [...] The preferred method of evaluating bone mass is the measurement of bone mineral density (BMD) of the spine and hip by dual energy X-ray absorptiometry (DEXA), which is also used to assess the response to therapy.4 The interpretation of BMD results is based on a comparison of a patient’s BMD with the mean value for a young adult population of the same sex and race. [...] If these were unavailable, we assumed a uniform drop-out rate for each year, and calculated the denominators by determining the proportion of subjects that would have remained at the end of the year in question, based on the number of withdrawals over the course of the study.