Potential of biomarkers during pharmacological therapy setting for postmenopausal osteoporosis: a systematic review.
Aged
Aged, 80 and over
Alkaline Phosphatase
/ blood
Biomarkers
/ blood
Bone Density
Bone Density Conservation Agents
/ adverse effects
Cefotaxime
/ analogs & derivatives
Collagen Type I
/ urine
Female
Humans
Middle Aged
Monitoring, Physiologic
Osteoporosis, Postmenopausal
/ diagnosis
Peptide Fragments
/ blood
Peptides
/ urine
Procollagen
/ blood
Randomized Controlled Trials as Topic
Biomarkers
NTx
Osteoporosis
PINP
bALP
bCTx
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
31 May 2021
31 May 2021
Historique:
received:
21
04
2021
accepted:
23
05
2021
entrez:
1
6
2021
pubmed:
2
6
2021
medline:
11
11
2021
Statut:
epublish
Résumé
Biochemical markers of bone turnover (BTMs), such as the bone alkaline phosphatase (bALP), procollagen type I N propeptide (PINP), serum cross-linked C-telopeptides of type I collagen (bCTx), and urinary cross-linked N-telopeptides of type I collagen (NTx), are used to manage therapy monitoring in osteoporotic patients. This systematic review analyzed the potential of these BMTs in predicting the clinical outcomes in terms of BMD, t-score, rate of fractures, and adverse events during the therapy setting in postmenopausal osteoporosis. All randomized clinical trials (RCTs) reporting data on biomarkers for postmenopausal osteoporosis were accessed. Only articles reporting quantitative data on the level of biomarkers at baseline and on the outcomes of interest at the last follow-up were eligible. A total of 36,706 patients were retrieved. Greater values of bALP were associated with a greater rate of vertebral (P = 0.001) and non-vertebral fractures (P = 0.0001). Greater values of NTx at baseline were associated with a greater rate of adverse events at the last follow-up (P = 0.02). Greater values of CTx at baseline were associated with a greater rate of adverse events leading to discontinuation (P = 0.04), gastrointestinal adverse events (P = 0.0001), musculoskeletal adverse events (P = 0.04), and mortality (P = 0.04). Greater values of PINP at baseline were associated with greater rates of gastrointestinal adverse events (P = 0.02) at the last follow-up. The present analysis supports the adoption of BMTs during pharmacological therapy setting of patients suffering from osteoporosis. I, systematic review of RCTs.
Sections du résumé
BACKGROUND
BACKGROUND
Biochemical markers of bone turnover (BTMs), such as the bone alkaline phosphatase (bALP), procollagen type I N propeptide (PINP), serum cross-linked C-telopeptides of type I collagen (bCTx), and urinary cross-linked N-telopeptides of type I collagen (NTx), are used to manage therapy monitoring in osteoporotic patients. This systematic review analyzed the potential of these BMTs in predicting the clinical outcomes in terms of BMD, t-score, rate of fractures, and adverse events during the therapy setting in postmenopausal osteoporosis.
METHODS
METHODS
All randomized clinical trials (RCTs) reporting data on biomarkers for postmenopausal osteoporosis were accessed. Only articles reporting quantitative data on the level of biomarkers at baseline and on the outcomes of interest at the last follow-up were eligible.
RESULTS
RESULTS
A total of 36,706 patients were retrieved. Greater values of bALP were associated with a greater rate of vertebral (P = 0.001) and non-vertebral fractures (P = 0.0001). Greater values of NTx at baseline were associated with a greater rate of adverse events at the last follow-up (P = 0.02). Greater values of CTx at baseline were associated with a greater rate of adverse events leading to discontinuation (P = 0.04), gastrointestinal adverse events (P = 0.0001), musculoskeletal adverse events (P = 0.04), and mortality (P = 0.04). Greater values of PINP at baseline were associated with greater rates of gastrointestinal adverse events (P = 0.02) at the last follow-up.
CONCLUSION
CONCLUSIONS
The present analysis supports the adoption of BMTs during pharmacological therapy setting of patients suffering from osteoporosis.
LEVEL OF EVIDENCE
METHODS
I, systematic review of RCTs.
Identifiants
pubmed: 34059108
doi: 10.1186/s13018-021-02497-0
pii: 10.1186/s13018-021-02497-0
pmc: PMC8165809
doi:
Substances chimiques
Biomarkers
0
Bone Density Conservation Agents
0
Collagen Type I
0
Peptide Fragments
0
Peptides
0
Procollagen
0
collagen type I trimeric cross-linked peptide
0
procollagen Type I N-terminal peptide
0
benzathine cefotaxime
127627-69-4
ALPL protein, human
EC 3.1.3.1
Alkaline Phosphatase
EC 3.1.3.1
Cefotaxime
N2GI8B1GK7
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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