Comparison of Efficacy of Pharmacologic Treatments in Pregnancy- and Lactation-Associated Osteoporosis

In this study, we aimed to summarise pharmacologic strategies and its efficacy on BMD change and subsequent fractures using individual case data or frequency-weighted group data from available literatures. Among 2438 studies identified using PubMed and Embase until Jan 2019, 30 studies which reported pharmacologic treatment (23 studies) or observation (7 studies) were included. Reported treatment options consisted of observation with calcium/vitamin D supplements (control,n = 32), bisphosphonates (BP,n = 31), teriparatide (TPTD,n = 40) and other strategies (vitamin K2 and strontium; other,n = 4). Median treatment duration and BMD follow-up duration was 27 and 35 months, respectively. Mean lumbar spine BMD measured by dual-energy x-ray absorptiometry was increased at 3-year follow-up in all groups (control, 7.9%; BP, 18.2%; TPTD, 17.0%; other, 8.6%;P <  0.05 for all), with significantly higher BMD change in BP or TPTD compared to control (Bonferroni-correctedP <  0.001 for all). Our findings suggest the potential long-term efficacy of pharmacologic treatments in individuals with PLO with high risk of subsequent fracture.
Source: Clinical Reviews in Bone and Mineral Metabolism - Category: Internal Medicine Source Type: research