 Identifying the most effective Osteoporosis medication for Bone Mineral Density loss in the Proximal Femur following Total Hip Arthroplasty: A Network Meta-analysis.

<h2 id="purpose">Purpose</h2><p>This study aimed to compare and rank the effectiveness of various drugs in preventing bone mineral density (BMD) loss one year after total hip arthroplasty (THA) through a network meta-analysis (NMA) of randomized controlled trials (RCTs).</p><h2 id="methods">Methods</h2><ul><li>A comprehensive literature search was conducted following the PRISMA guidelines, using databases such as MEDLINE the Cochrane Central Register of Controlled Trials, and CINAHL.</li><li>Only RCTs evaluating the effectiveness of currently available osteoporosis medications in preventing periprosthetic BMD loss were included.<br>A multivariate random-effects NMA, employing a frequentist consistency model, was used to integrate both direct and indirect comparisons of treatments as shown in figure 1.</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/ortho-fig1.webp" width="690" height="505"></p><ul><li>The P-score, the frequentist analog to the surface under the cumulative ranking (SUCRA) probabilities, was used to determine the efficacy ranking.</li><li>A total of 17 RCTs were included. The pairwise mean differences (95% confidence intervals) in BMD changes showed that teriparatide was the most effective drug in both Zone 1 and Zone 7 as shown in figure 2.</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/ortho-fig2.webp" width="709" height="487"></p><ul><li>In the predicted treatment rankings for BMD changes, teriparatide was ranked as the top intervention for both zone 1 (P-score = 0.8844) and zone 7 (P-score = 0.9044).</li></ul><h2 id="conclusion">Conclusion</h2><p>The findings suggest that teriparatide, along with zoledronic acid, alendronate, and, etidronate, may be effective options for preventing periprosthetic BMD loss in Zone 1 and Zone 7 one year after THA.</p>

<ul><li><a href="#purpose">Purpose</a></li><li><a href="#methods">Methods</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Identifying the most effective Osteoporosis medication for Bone Mineral Density loss in the Proximal Femur following Total Hip Arthroplasty: A Network Meta-analysis.

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