Conservative Treatments in the Management of Acute Painful Vertebral Compression Fractures: A Systematic Review and Network Meta-Analysis
Authors' conclusion
NSAIDs and teriparatide may be the preferred treatment options for pain management in acute osteoporotic VCF.
Study context
- Population
- Patients with acute osteoporotic vertebral compression fractures (VCFs)
- Participants
- 2,102 patients20 trials
- Comparison
- Conservative treatments compared with each other and placebo
- Outcome
- Short-term pain during activity and long-term nonspecified pain
- Follow-up
- 4 weeks (short-term); latest available (long-term)
Methodological detailsPRISMA for network meta-analyses, frequentist graph-theoretical model, random-effects model
- PRISMA for network meta-analyses
- Frequentist graph-theoretical model
- Random-effects model
Pooled result
As reported in the abstract
Short-term pain during activity · 4 weeks
Each group vs placeboSMD (95% CI)
Calcitonin
−4.86(−6.87 to −2.86)
NSAIDs
−3.94(−7.30 to −0.58)
Further pooled results
| Outcome | SMD (95% CI) | |
|---|---|---|
| Co-primary: long-term nonspecific pain · latest available follow-upBisphosphonatesvs Teriparatide dailyBisphosphonates associated with inferior pain outcomes | 1.21 (0.11–2.31) | |
| Co-primary: long-term nonspecific pain · latest available follow-upBisphosphonatesvs Teriparatide weeklyBisphosphonates associated with inferior pain outcomes | 1.13 (0.05–2.21) | |
| −10123Difference (linear scale) |
Co-primary: long-term nonspecific pain · latest available follow-up
- No treatment superior to nonsteroidal anti-inflammatory drugs (NSAIDs)
Original publication
Conservative Treatments in the Management of Acute Painful Vertebral Compression Fractures: A Systematic Review and Network Meta-Analysis. JAMA Netw Open. Published 3 September 2024. doi:10.
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