Outcomes of bisphosphonate and its supplements for bone loss in kidney transplant recipients: a systematic review and network meta-analysis

Yang, Yan; Qiu, Shi; Deng, Liangliang; Tang, Xi; Li, Xinrui; Wang, Qiang

doi:10.1186/s12882-018-1076-1

Cited by 5 publications

(3 citation statements)

References 45 publications

(75 reference statements)

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“…Indeed, in a recent meta-analysis including 18 randomized controlled trials with a total of 1200 kidney recipients with long-term steroid therapy (median follow up of 12 months), bisphosphonate plus calcium and/or vitamin D revealed a significant gain in percent BMD change than calcium and/or vitamin D alone at the femoral neck (mean difference, 5.83, 95% credible interval, 1.61-9.27) and at the lumbar spine (mean difference, 5.48, 95% credible interval, 2.57-8.42). 43 Thus, in our population, ESW had much the same positive effect on BMD as specific antiosteoporotic treatments do in kidney recipients with long-term steroid therapy. The spontaneous BMD gain observed in our ESW group might be related to the restoration of normal calcium, phosphate and calcitriol levels and the absence of the steroids' harmful effects on bone.…”

Section: Discussionmentioning

confidence: 51%

Early steroid withdrawal has a positive effect on bone in kidney transplant recipients: a propensity score study with inverse probability-of-treatment weighting

Batteux

Gras‐Champel

Lando

et al. 2020

Therapeutic Advances in Musculoskeletal

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Background: Long-term corticosteroid use after kidney transplantation is associated with a decrease in bone mineral density (BMD) and a high fracture risk. We hypothesized that patients with early steroid withdrawal (ESW) would display a gain in BMD in the year following kidney transplantation, when compared with patients on long-term corticosteroid therapy. Methods: In a cohort of kidney transplant recipients, 356 patients were included between 2012 and 2019. Dual-energy X-ray absorptiometry was performed 1 and 12 months after transplantation. The data were analyzed using linear regression with inverse probability-of-treatment weighting (based on a propensity score). Results: At 1 year after transplantation, the gain in BMD was significantly greater in recipients with ESW than in recipients on long-term corticosteroid therapy for the lumbar spine (+0.036 g/cm2, p < 0.001) and the femoral neck (+0.020 g/cm2, p = 0.035). Among patients with ESW, (i) none had osteoporosis, (ii) the percentage with normal BMD increased from 33.3% at month 1 to 54.4% at month 12, and (iii) the percentage with osteopenia fell from 56.2% to 45.6%. In patients undergoing long-term corticosteroid therapy, the fracture incidence was 13.5 per 1000 person-years. None of the patients in the ESW group experienced a fracture. Conclusion: ESW has a positive effect on bone in kidney transplant recipients.

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Section: Discussionmentioning

confidence: 51%

Early steroid withdrawal has a positive effect on bone in kidney transplant recipients: a propensity score study with inverse probability-of-treatment weighting

Batteux

Gras‐Champel

Lando

et al. 2020

Therapeutic Advances in Musculoskeletal

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“…In contrast with these findings, a network meta-analysis showed that the combined therapy of bisphosphonate, with calcium and vitamin D analogs, improved BMD at LV and FN. However, when the authors performed an indirect comparison of bisphosphonate plus calcium use with or without vitamin D analogue supplementation, no difference in BMD was found [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Cholecaciferol Supplementation on Bone Mineral Density in Long-Term Kidney Transplant Recipients

et al. 2023

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Although reduced bone mineral density (BMD) is associated with a higher risk of fractures, morbidity, and mortality in kidney transplant patients (KTRs), there is no consensus on optimal treatment for the alterations of BMD in this population. This study aims at assessing the effect of cholecalciferol supplementation on BMD over a follow-up period of 2 years in a cohort of long-term KTRs. Patients with age ≥ 18 years were included and divided into two subgroups based on treatment with bisphosphonate and/or calcimimetics and/or active vitamin D sterols (KTRs-treated) or never treated with the above medications (KTRs-free). BMD was evaluated at lumbar vertebral bodies (LV) and right femoral neck (FN) with standard DEXA at the beginning and end of the study. According to World Health Organization (WHO) criteria, results were expressed as T-score and Z-score. Osteoporosis and osteopenia were defined as T score ≤ −2.5 SD and T score < −1 and >−2.5 SD, respectively. Cholecalciferol was supplemented at a dose of 25,000 IU/week over 12 weeks followed by 1500 IU/day. KTRs-free (n. 69) and KTRs-treated (n. 49) consecutive outpatients entered the study. KTRs-free were younger (p < 0.05), with a lower prevalence of diabetes (p < 0.05) and of osteopenia at FN (46.3 % vs. 61.2 %) compared to KTRs-treated. At the entry none of the study subjects had a sufficient level of cholecalciferol; Z-score and T-score at LV and FN were not different between groups. At the end of the study period, serum cholecalciferol concentration was significantly increased in both groups (p < 0.001); the KTRs-free group presented an improvement in both T-score and Z-score at LV (p < 0.05) as well as a lower prevalence of osteoporotic cases (21.7% vs. 15.9%); in contrast, no changes were recorded in KTR-treated individuals. In conclusion, supplementation with cholecalciferol ameliorated Z-score and T-score at LV in long-term KTRs who had been never treated with active or inactive vitamin D sterols, bisphosphonates, and calcimimetics. Future endeavours are needed to confirm these preliminary findings.

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“…Existen publicaciones de MTC en áreas como reumatología [15][16][17][18][19][20][21] , psiquiatría [22][23][24][25][26][27] , oncología [28][29][30] , oftalmología [31][32][33] , cardiología [34][35][36][37][38] , cirugía 33 , dermatología [39][40][41][42] , neumología [43][44][45][46][47] , medicina interna [48][49][50][51][52] , urología 53 , ortopedia [54][55] , ginecología [56][57] o nefrología [58][59] .…”

Section: Ejemplos De Mtcunclassified

Aproximación a los metanálisis de comparación de múltiples tratamientos: una revisión de la literatura

Gómez¹,

Isaza

Gómez

2019

MedUPB

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RESUMENLos metanálisis de comparación de múltiples tratamientos permiten estudiar, a partir de revisiones sistemáticas, las comparaciones realizadas de forma directa o indirecta, sobre diversos tipos de intervenciones, con datos de varios ensayos clínicos que, por su homogeneidad en los resultados, pueden agruparse en un resultado común y expresable de manera cuantitativa. Otros nombres que recibe son: metanálisis en red, metanálisis de comparación mixta o metanálisis indirectos. Al permitir la comparación de varios tratamientos facilitan una mejor estimación del efecto de las intervenciones, lo que guía de forma más certera al clínico en sus decisiones y en la aplicación de la información en el cuidado de sus pacientes. El objetivo de esta revisión es guiar al lector para que realice de manera organizada y adecuada la lectura crítica (según recomendaciones JAMA) de los metanálisis de comparación de múltiples tratamientos. Este artículo está orientando a los autores y a los editores, y contiene información sobre cómo deben interpretarse y comunicarse estos estudios. Palabras clave: metanálisis como asunto; terapéutica; práctica clínica basada en la evidencia ABSTRACT Multiple treatment comparison meta-analyses are systematic reviews that allow to make direct or indirect comparisons of different interventions from the data collection results of randomized clinical trials, grouping them in a common outcome or conglomerate which is expressed quantitatively. Other names given are network meta-analyses, or mixed treatment comparison meta-analyses or indirect meta-analyses. The use of the comparison of several treatments allows a greater estimation of the intervention effect. This is a guide for the physician to make more accurate decisions and to apply better care criteria to their patients. This literature review should help the reader to perform an organized and adequate critical reading (according to the JAMA recommendations) of the multiple treatment comparison meta-analyses. The article is addressed to authors and editors, and it contains information on how this type of studies should be interpreted and communicated.

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Outcomes of bisphosphonate and its supplements for bone loss in kidney transplant recipients: a systematic review and network meta-analysis

Cited by 5 publications

References 45 publications

Early steroid withdrawal has a positive effect on bone in kidney transplant recipients: a propensity score study with inverse probability-of-treatment weighting

Early steroid withdrawal has a positive effect on bone in kidney transplant recipients: a propensity score study with inverse probability-of-treatment weighting

The Impact of Cholecaciferol Supplementation on Bone Mineral Density in Long-Term Kidney Transplant Recipients

Aproximación a los metanálisis de comparación de múltiples tratamientos: una revisión de la literatura

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