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The Efficacy and Safety of Bisphosphonates for Osteoporosis or Osteopenia in Crohn’s Disease: A Meta-Analysis

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Abstract

Background

Crohn’s disease impacts the bone health of patients and results in a high prevalence of low bone mineral density (BMD) disease such as osteoporosis and osteopenia. Bisphosphonates can reduce bone loss by inhibiting bone resorption.

Aim

To assess the effectiveness and safety of bisphosphonates for osteoporosis or osteopenia in Crohn’s disease.

Methods

A literature search included PubMed, EMBASE, the Science Citation Index, and the Cochrane Library was conducted to identify studies up to March, 2012. Randomized controlled trials (RCTs) comparing bisphosphonates with placebo or no intervention for osteoporosis or osteopenia in adult patients with Crohn’s disease were analyzed.

Results

Five RCTs involving 423 participants were included. All patients received daily calcium and vitamin D supplementation. Overall, bisphosphonates improved hip BMD at 12 months (n = 193, MD = 0.99, 95 % CI: 0.14–1.84) compared with placebos or no intervention. No significant differences of spine BMD at both 12 months (n = 193, MD = 1.78, 95 % CI: −0.99 to 4.55) and 24 months (n = 231, MD = 0.70 %, 95 % CI: −0.48 to 1.88), hip BMD at 24 months (n = 231, MD = 0.25 %, 95 % CI: −0.65 to 1.15), new vertebral fractures (n = 117, RD = −0.01, 95 % CI: −0.08 to 0.05) or adverse events (n = 422, RR = 1.03, 95 % CI: 0.71–1.49) between bisphosphonates groups and control groups were noted. Subgroup analyses of participants treated with corticosteroid in the preceding year found no difference between two groups.

Conclusions

There was no evidence to support the use of bisphosphonates for osteoporosis or osteopenia in Crohn’s disease. More randomized controlled clinical trials assessing the effects of bisphosphonates are needed.

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Authors and Affiliations

  1. Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, People’s Republic of China

    Zhen Guo, Rong Wu, Jianfeng Gong, Weiming Zhu, Yi Li, Ning Li & Jieshou Li

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  1. Zhen Guo
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  2. Rong Wu
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  3. Jianfeng Gong
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Correspondence to Weiming Zhu.

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Guo, Z., Wu, R., Gong, J. et al. The Efficacy and Safety of Bisphosphonates for Osteoporosis or Osteopenia in Crohn’s Disease: A Meta-Analysis. Dig Dis Sci 58, 915–922 (2013). https://doi.org/10.1007/s10620-012-2465-0

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