Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis
Authors' conclusion
The significance of small positive effect of anti-resorptives on aortic stenosis is clinically uncertain. Despite strong biological links between vascular calcification and skeletal mineralisation, anti-resorptives do not appear to have a strong favourable influence on extra-skeletal mineralisation. This suggests that mechanisms that link vascular calcification with osteoporosis may be acting in pathways not influenced by anti-resorptives. This systematic review and meta-analysis summarises the effect of anti-resorptives on vascular and valvular calcification. There is a small, positive effect of anti-resorptives on aortic stenosis, though this is of uncertain clinical importance.
Study context
- Population
- Studies of anti-resorptive medication use and vascular/valvular calcification across populations; Medline and Embase, inception to October 202415 studies meta-analysed
- Participants
- 2,344 participants
- Comparison
- Anti-resorptive medication use and vascular/valvular calcification
- Outcome
- Vascular and valvular calcification with anti-resorptive use
Methodological detailsrandom-effects model, leave-one-out sensitivity analyses, 4071 articles screened; 33 included in review; 15 with data for meta-analysis
- Random-effects model
- Leave-one-out sensitivity analyses
- 4071 articles screened; 33 included in review; 15 with data for meta-analysis
Pooled result
As reported in the abstract
- Non-significant, small improvements in abdominal aortic calcification (decreased value), coronary artery calcification (decreased value) and ejection fraction (increased value) with anti-resorptives
- Significant small reduction in aortic valve area (representing less calcification on the valve) with anti-resorptives
- Standardised mean differences (SMDs) printed without a clear assignment to outcomes (more values printed than outcomes named with "respectively")
- Random-effects model
- Pooled SMDs with 95% CI
Original publication
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