porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo13150porozendo-13150Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯCLINICAL GUIDELINESПрименение бисфосфонатов для профилактики остеопоротических переломов у женщин с остеопенией в постменопаузе: систематический обзор и метаанализBisphosphonates for the prevention of osteoporotic fractures in postmenopausal women with osteopenia: a systematic review and meta-analysishttps://orcid.org/0000-0003-2864-066XЮреневаС. В.YurenevaS. V.

Светлана Владимировна Юренева, д. м. н., профессор

117997; ул. Академика Опарина, д. 4; Москва

Scopus Author ID: 56299444500

Svetlana V. Yureneva

117997; Academic Oparin street, 4; Moscow

Scopus Author ID: 56299444500

syureneva@gmail.comhttps://orcid.org/0000-0002-8584-5517АверковаВ. Г.AverkovaV. G.

Виктория Геннадьевна Аверкова, аспирант

Москва

Scopus Author ID: 57213597365

Victoria G. Averkova, MD

Moscow

Scopus Author ID: 57213597365

buch1202@mail.ruФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова» Минздрава РоссииРоссияNational medical research center for obstetrics, gynecology and perinatology named after academician V.I. KulakovRussian Federation2024170420242712134Copyright © Юренева С.В., Аверкова В.Г., 20242024Юренева С.В., Аверкова В.Г.Yureneva S.V., Averkova V.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/13150   ОБОСНОВАНИЕ

   ОБОСНОВАНИЕ. Отсутствие достаточной систематизации данных по применению бисфосфонатов для первичной профилактики остеопоротических переломов (ОП) у женщин в постменопаузе с остеопенией побудило нас провести систематический обзор с метаанализом публикаций, посвященных данной проблеме.

   ЦЕЛЬ

   ЦЕЛЬ. Изучить влияние бисфосфонатов на минеральную плотность кости (МПК) и переломы у женщин в постменопаузе с остеопенией.

   МАТЕРИАЛЫ И МЕТОДЫ

   МАТЕРИАЛЫ И МЕТОДЫ. При первичном отборе было найдено 1140 потенциально подходящих статей. Из первоначально идентифицированных результатов был проведен метаанализ 13 исследований. Дизайн отобранных для метаанализа исследований соответствовал рандомизированным контролируемым исследованиям (РКИ).

   РЕЗУЛЬТАТЫ

   РЕЗУЛЬТАТЫ. В среднем исследуемые препараты бисфосфонатов по сравнению с плацебо увеличивали МПК поясничного отдела позвоночника на 5,54 % (95 % ДИ 4,44–6,63, I2=93,65 %), общую МПК бедра на 4,53 % (95 % ДИ 3,2–5,86, I2=96,32 %), МПК шейки бедра на 3,63 % (95 % ДИ 1,5–5,75, I2 = 95,9 %), МПК всего тела на 3,25 % (95 % ДИ 2,28–4,22, I2 = 87,87 %), МПК проксимального отдела бедра на 4,76 % (95 % ДИ 3,43–6,08, I2 = 88,64 %). Выявлено статистически значимое влияние бисфосфонатов на низкоэнергетические переломы (ОР 0,62; 95 % ДИ 0,49–0,77), клинические переломы позвонков (ОР 0,51; 95 % ДИ 0,38–0,69), а также рентгенологически подтверждённые переломы позвонков (ОР 0,63; 95 % ДИ 0,4–0,98).

   ЗАКЛЮЧЕНИЕ

   ЗАКЛЮЧЕНИЕ. Полученные результаты позволяют заключить, что бисфосфонаты (алендронат, золедроновая кислота, ибандронат, резедронат) обладают положительным терапевтическим эффектом, и их назначение оправдано у женщин в постменопаузе с остеопенией для профилактики ОП и увеличения МПК.

   BACKGROUND

   BACKGROUND: The lack of sufficient systematization of data on the use of bisphosphonates for primary prevention of osteoporotic fractures in postmenopausal women with osteopenia prompted us to conduct a systematic review with meta-analysis of publications devoted to this problem.AIM: To study the effect of bisphosphonates on bone mineral density (BMD), markers of bone metabolism and fractures in postmenopausal women with osteopenia.

   MATERIALS AND METHODS

   MATERIALS AND METHODS: A total of 1140 potentially eligible articles were found in the initial publication screening. From the initially identified results, 13 studies were meta-analyzed. The design of the studies selected for meta-analysis was consistent with randomized controlled trials.

   RESULTS

   RESULTS: On average, study bisphosphonate preparations compared with placebo increased lumbar spine BMD by 5.54 % (95 % CI 4.44–6.63, I2 = 93.65 %), total hip BMD by 4.53 % (95 % CI 3. 2–5.86, I2=96.32 %), femoral neck BMD by 3.63 % (95 % CI 1.5–5.75, I2=95.9 %), total body BMD by 3.25 % (95 % CI 2.28–4.22, I2=87.87 %), proximal femur BMD by 4.76 % (95 % CI 3.43–6.08, I2 = 88.64 %). There was a statistically significant effect of bisphosphonates on low-energy fractures (OR 0.62; 95 % CI 0.49–0.77), clinical vertebral fractures (OR 0.51; 95 % CI 0.38–0.69), and radiologically confirmed vertebral fractures (OR 0.63; 95 % CI 0.4–0.98).

   CONCLUSION

   CONCLUSION: These results obtained allow us to conclude that bisphosphonates (alendronate, zolendronic acid, ibandronate, resedronate) have a positive therapeutic effect, and their administration is justified in postmenopausal women with osteopenia for the prevention of osteoporotic fractures and increase in BMD.

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The authors declare that there are no conflicts of interest present.