Comparative Effectiveness of Therapeutic Interventions in Pregnancy and Lactation-Associated Osteoporosis: A Systematic Review and Meta-analysis
Authors' conclusion
Due to high heterogeneity and lack of robust comparative data, no safe conclusions can be made regarding the optimal therapeutic intervention in women with PLO.
Study context
- Population
- Women with pregnancy and lactation-associated osteoporosis (PLO) receiving any antiosteoporosis therapy; secondary osteoporosis and transient osteoporosis of the hip excluded; age range 19–42 years
- Participants
- 451 women66 studies
- Comparison
- Antiosteoporosis therapies in PLO
- Outcome
- BMD and risk of fractures
Methodological detailsPubMed/Scopus searched until December 20, 2022, Data extraction independently by 2 researchers
- PubMed/Scopus searched until December 20, 2022
- Data extraction independently by 2 researchers
Pooled result
As reported in the abstract
Increase in lumbar spine (LS) BMD · 12 months
Calcium/vitamin D (CaD)
2.0% to 7.5%
Bisphosphonates
5.0% to 41.5%
Teriparatide
8.0% to 24.4%
Further pooled results
| Outcome | WMD (%) (95% CI) | |
|---|---|---|
| Meta-analysis: LS BMD increaseTeriparatidevs CaDI2 50.9%; greater increase with teriparatide | 11.5 (4.9–18.0%) | |
| Meta-analysis: FN BMD increaseTeriparatidevs CaDI2 8.1%; greater increase with teriparatide | 5.4 (1.2–9.6%) | |
| −1001020Difference, % (linear scale) |
| Outcome | CaD | Bisphosphonates | Teriparatide |
|---|---|---|---|
| Increase in LS BMD · 24 months | 11.0% to 12.2% | 10.2% to 171.9% | 24.1% to 32.9% |
| Increase in femoral neck (FN) BMD · 18-24 months | 6.1% | 0.7% to 18% | 8.4% to 18.6% |
- Meta-analysis: Lumbar spine (LS) bone mineral density (BMD) increase: meta-analysis of 2 interventional studies only
- Meta-analysis: Femoral neck (FN) BMD increase: meta-analysis of 2 interventional studies only
Original publication
Comparative Effectiveness of Therapeutic Interventions in Pregnancy and Lactation-Associated Osteoporosis: A Systematic Review and Meta-analysis. J Clin Endocrinol Metab. Published 14 September 2023. doi:10.
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