Ibandronate in the Prevention of Vertebral and Nonvertebral Osteoporotic Fractures

Abstract

Background/Objective: This study aims to evaluate ibandronate clinical effectiveness in the prevention of osteoporosis-related vertebral fractures (VFs) and nonvertebral fractures (NVFs) in the treatment of postmenopausal osteoporosis.Methods: This systematic review was conducted in accordance with 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. A literature search was performed in PubMed and EMBASE since their inception until February 7, 2022. Randomized controlled trials (RCTs), meta-analysis, experimental, and observational studies evaluating adult patients treated with ibandronate and assessed to osteoporotic fractures prevention were included. The risk of bias was assessed according to study design. Data were analyzed using descriptive statistics.Results: Eight references from 4 RCTs, 7 meta-analyses, and 6 observational studies were included. In RCTs, oral ibandronate was superior to placebo in the prevention of VF. However, the doses were lower than those approved. The meta-analyses confirmed these results and showed that adequate doses of oral ibandronate reduce the risk of NVF compared with insufficient doses. In observational studies, oral ibandronate (in approved doses) reduced the risk of VF compared with no treatment or risedronate or alendronate and the risk of NVF versus risedronate or alendronate; the risk of hip fractures was similar between ibandronate and other oral bisphosphonates.Conclusions: There is strong evidence that ibandronate reduces the risk of VF in postmenopausal osteoporosis. The available evidence further suggests that ibandronate may reduce the risk of NVF versus insufficient doses of ibandronate, as well as risedronate or alendronate.

The effectiveness of ibandronate in reducing the risk of nonvertebral fractures in women with osteoporosis: systematic review and meta-analysis of observational studies

“…This meta-analysis of observational studies evaluates the effectiveness of ibandronate in preventing osteoporotic nonvertebral fracture. There are reasons why this study stands out from a previous systematic review evaluating the antifracture benefit of ibandronate [ 20 ]. First, this meta-analysis is supported by an updated literature search which identified a new study [ 29 ].…”

“…Literature search followed the strategy from a systematic review evaluating ibandronate in preventing osteoporotic fractures [ 20 ]. The search strategy was applied to Pubmed and Embase, and duly updated through May 23rd, 2023 (Table S1 ).…”