The effect of teriparatide on fracture healing after atypical femoral fracture: A systematic review and meta-analysis
Authors' conclusion
The current meta-analysis supported the hypothesis that TPTD treatment following AFF might benefit fracture healing, lowering the rate of delayed union and nonunion and shortening the fracture healing time.
Study context
- Population
- Patients with atypical femoral fracture (AFF); studies from MEDLINE (PUBMED), Embase and Cochrane Library up to October 11, 2022
- Participants
- 214 patients6 studies
- Comparison
- Postfracture teriparatide vs no TPTD after atypical femoral fracture
- TPTD ( +)n = 93
- TPTD (-)n = 121reference
- Outcome
- Delayed union, nonunion and fracture healing time
Methodological detailspairwise meta-analysis
- Pairwise meta-analysis
Pooled result
As reported in the abstract
Delayed union, nonunion and time to fracture union
TPTD ( +) vs TPTD (-)Odds ratio (95% CI)P value
Delayed union; higher rate with TPTD (-); I2 = 0%
0.24(0.11–0.52)
P < 0.01Nonunion; higher rate with TPTD (-); I2 = 0%
0.21(0.06–0.78)
P = 0.02- Time to fracture union; 1.69 months longer with TPTD (-); I2 = 13%
- MD - 1.69 months (95% CI - 2.44 to - 0.95); P < 0.01
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Subgroup: complete AFF — delayed union, nonunion, fracture healing timeTPTD ( +)vs TPTD (-)Delayed union; higher rate with TPTD (-); I2 = 0% | 0.22 (0.10–0.51) | P < 0.01 | |
| Subgroup: complete AFF — delayed union, nonunion, fracture healing timeTPTD ( +)vs TPTD (-)Nonunion; no significant difference; I2 = 0% | 0.35 (0.06–2.21) | P = 0.25 | |
| Reoperation rateBetween TPTD ( +) and TPTD (-) · I2 = 0% | 0.29 (0.07–1.20) | P = 0.09 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | MD (95% CI) | P value |
|---|---|---|
| Subgroup: complete AFF — delayed union, nonunion, fracture healing timeTPTD ( +) vs TPTD (-) · Fracture healing time; longer with TPTD (-); I2 = 48% | - 1.81 (- 2.55 to - 1.08) | P < 0.01 |
Original publication
The effect of teriparatide on fracture healing after atypical femoral fracture: A systematic review and meta-analysis. Osteoporos Int. Published 25 April 2023. doi:10.
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