Safety profile of drugs used in the treatment of osteoporosis: a systematical review of the literature

Submitted: 26 July 2013
Accepted: 15 October 2013
Published: 31 October 2013
Abstract Views: 6482
PDF: 2292
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The range of osteoporosis treatments is increasingly large and, like any disease, the pharmacological management of patients should involve a risk/benefit evaluation to attain the greatest reduction in risk of fracture with the lowest incidence of adverse events. The aim of this review is to critically appraise the literature about the safety issues of the main pharmacological treatments of osteoporosis. This document is the result of a consensus of experts based on a systematic review of regulatory documents, randomized controlled trials, metaanalyses, pharmacovigilance surveys and case series related to possible adverse drug reactions to osteoporosis treatment with calcium and vitamin D supplements, bisphosphonates, strontium ranelate, selective estrogen receptor modulators, denosumab, and teriparatide. As expected, randomized controlled trials showed only the most common adverse events due to the samples size and the short observation time. Case series and observational studies are able to provide data about uncommon side effects, but in some cases a sure cause-effect relationship needs still to be confirmed. Consistently with methodological limitations, the newer drugs have a tolerance profile that has not been fully explored yet. Osteoporosis treatments showed an overall good tolerance profile with rare serious adverse events that, however, must be well known by the clinician who prescribes these drugs. The concern about possible adverse events should be weighed against the reduction of morbidity and mortality associated with a significant fracture risk reduction.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

M. Varenna, Bone Diseases Unit, Department of Rheumatology, Gaetano Pini Institute, Milan

Centro per la Diagnosi e il Trattamento delle patologie Osteometaboliche. Day Hospital di Reumatologia.

Istituto Gaetano Pini. Milano.

F. Bertoldo, Department of Biomedical and Surgical Sciences, Unit of Diseases of Mineral Metabolism and the Bone, University of Verona, Verona

Dipartimento di Scienze Biomediche e Chirurgiche, Clinica di Medicina Interna D, Università degli Studi di Verona, Italia

 

M. Di Monaco, Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, San Camillo Hospital, Torino

Centro Specializzato in Malattie Metaboliche dell'Osso. Divisione di Medicina Fisica e Riabilitazione. Presidio Sanitario San Camillo, Torino

 

A. Giusti, Bone Clinic, Department of Geriatrics and Musculoskeletal Sciences, E.O. Galliera Hospital, Genova
Dipartimento di Gerontologia e Scienze Motorie. Ospedale Galliera. Genova
G. Martini, Department of Medical, Surgical and Neurological Sciences University of Siena, Siena
Professore Associato. Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze. Università di Siena. Siena
M. Rossini, Rheumatology Section, Department of Medicine, University of Verona, Verona
Professore aggregato. Sezione di Reumatologia. Dipartimento di Medicina
Università di Verona

How to Cite

Varenna, M., Bertoldo, F., Di Monaco, M., Giusti, A., Martini, G., Rossini, M., SIOMMMS, O. behalf of, & SIR, E. by. (2013). Safety profile of drugs used in the treatment of osteoporosis: a systematical review of the literature. Reumatismo, 65(4), 143–166. https://doi.org/10.4081/reumatismo.2013.143