The following is a summary of “Ibandronate in the Prevention of Vertebral and Nonvertebral Osteoporotic Fractures: A Systematic Review of Experimental and Observational Studies,” published in the March 2023 issue of Rheumatology by Mendes, et al.
For a study, researchers sought to evaluate the clinical effectiveness of ibandronate in preventing osteoporosis-related vertebral fractures (VFs) and nonvertebral fractures (NVFs) in treating postmenopausal osteoporosis.
A systematic review was conducted, following the Centre for Reviews and Dissemination’s guidance, and reporting in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement 2020. PubMed and EMBASE were searched from inception to February 7, 2022, to include randomized controlled trials (RCTs), meta-analyses, and experimental and observational studies that evaluated adult patients treated with ibandronate-assessed osteoporotic fracture prevention. The risk of bias was evaluated according to the study design, and data were analyzed using descriptive statistics.
There were 8 references, four RCTs, seven meta-analyses, and 6 observational investigations. Ibandronate orally was more effective than a placebo in preventing VF in RCTs. The doses were, however, less than those that were authorized. The findings were supported by the meta-analyses, which also showed that the risk of NVF is decreased with adequate dosages of oral ibandronate instead of insufficient amounts. In observational studies, oral ibandronate (at approved doses) decreased the risk of VF over no treatment and the risk of NVF versus risedronate or alendronate. The risk of hip fractures was comparable between ibandronate and other oral bisphosphonates.
The study provided strong evidence that ibandronate reduced the risk of VF in postmenopausal osteoporosis. The evidence further suggests that ibandronate may reduce the risk of NVF versus insufficient doses of ibandronate, risedronate, or alendronate.