Effectiveness of combined Vitamin D and Bisphosphonate therapy in managing postmenopausal Osteoporosis: A systematic review and Meta-analysis. 

<h2 id="objective">Objective</h2><p>To evaluate if combining vitamin D and Bisphosphonates is more effective than using them alone in treating postmenopausal osteoporosis.</p><h2 id="methods">Methods</h2><p>A review of RCTs until February 1, 2024, compared Vit D or Bisphosphonates alone to its combination therapy in postmenopausal osteoporosis.<br>Reviewers assessed bone markers, BMD, and mineral metabolism using SMD and 95% Cl, analyzing heterogeneity with 12 and conducting subgroup analyses by monotherapy type.</p><h2 id="results">Results</h2><p><strong>Bone Markers and Mineral Metabolism:&nbsp;</strong></p><ul><li>Combination therapy of Vit D and Bisphosphonates showed a more significant improvement in <strong>alkaline phosphatase (ALP), 25-hydroxyvitamin D (25-0H-VD), and serum calcium (sCa) levels.</strong></li><li>Combination therapy showed more pronounced decrease in <strong>serum bone-specific alkaline phosphatase (sBALP), serum C-terminal telopeptide of type I collagen (sCTX), and urinary N-telopeptide of type I collagen (UriNTX)</strong> compared to monotherapy.</li><li><strong>Osteocalcin</strong>: There was no significant difference between the combination therapy and monotherapy in terms of improving <strong>osteocalcin</strong> levels (SMD, p &gt; 0.05).</li><li><strong>Parathyroid Hormone (PTH):</strong> Percentage change in <strong>parathyroid hormone (PTH)</strong> was not statistically significant between the two groups.</li></ul><p><strong>Bone Mineral Density (BMD): </strong>Combination therapy led to a more favorable effect on bone mineral density compared to monotherapy, suggesting that combining Vit D and Bisphosphonates may have enhanced effects on bone health in postmenopausal women.</p><h2 id="conclusion">Conclusion</h2><p>The meta-analysis indicates that the combination therapy of Vit D and Bisphosphonates is more effective than monotherapy in improving bone mineral density and bone calcium metabolism-related markers in the treatment of postmenopausal osteoporosis.</p>

Ortho Update   Issue 6   Nov 2024

<ul><li><a href="#objective">Objective</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Effectiveness of combined Vitamin D and Bisphosphonate therapy in managing postmenopausal Osteoporosis: A systematic review and Meta-analysis.

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