Bisphosphonates for osteoporosis in people with cystic fibrosis

Conwell, Louise S. and Chang, Anne B. (2014) Bisphosphonates for osteoporosis in people with cystic fibrosis. Cochrane Database of Systematic Review, 3: CD002010.1-CD002010.40. doi:10.1002/14651858.CD002010.pub4

Author Conwell, Louise S.
Chang, Anne B.
Title Bisphosphonates for osteoporosis in people with cystic fibrosis
Journal name Cochrane Database of Systematic Review   Check publisher's open access policy
ISSN 1469-493X
Publication date 2014-03-14
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/14651858.CD002010.pub4
Open Access Status
Issue 3
Start page CD002010.1
End page CD002010.40
Total pages 40
Place of publication Oxford, United Kingdom
Publisher John Wiley & Sons
Collection year 2015
Language eng
Formatted abstract
Cystic fibrosis is a serious genetic disorder that affects many organs (e.g. lung and pancreas). It commonly leads to reduced bone mineral density, known as osteoporosis, which increases the likelihood of fractures. The short-term and long-term effects of fractures (e.g. rib and vertebral) may make lung disease worse. Bisphosphonates are drugs that increase bone mineral density by slowing down bone resorption. They are used to treat osteoporosis caused by menopause or the use of corticosteroid drugs.

The evidence available was limited to six trials with participants who had not undergone lung transplants (total of 203 adults) and one trial with 34 adults who had undergone lung transplantation. Bisphosphonates consistently increased bone mineral density at the lumbar spine and hip regions. The rates of fractures (vertebral and non-vertebral) or deaths were not reduced by bisphosphonate therapy. However, this may be related to the small numbers of participants involved and the short duration of the trials. Severe bone pain and flu-like symptoms were commonly linked to intravenous bisphosphonates, especially in people not using corticosteroids. More research is needed to assess the effect of pre-treatment with corticosteroids. Additional trials are needed to determine if bone pain is more common or severe (or both) with the stronger drug zoledronate and if corticosteroids lessen or prevent these adverse events. Additional trials are also required to further assess gastrointestinal adverse effects associated with oral bisphosphonates. Trials in larger populations are needed to determine effects on fracture rate and survival.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
Queensland Children's Medical Research Institute Publications
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
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Created: Mon, 22 Dec 2014, 12:48:44 EST by Dr Louise Conwell on behalf of Paediatrics & Child Health - RBWH