Meta-analysis Of The Efficacy And Safety Of Romozumab In The Treatment Of Osteoporosis

Objective(s):A systematic meta-analysis to evaluate the efficacy and safety of Romosozumab in the treatment of osteoporosis.Methods:Computer retrieval,the Cochrane Library,Embase,Pubmed,Web of SCIence,China journal full-text database(CNKI),VIP,Chinese biomedical literature database(CBM),the ten thousand square medicine such as database about romosozumab Randomized controlled trials for the treatment of patients with osteoporosis(Randomized controlled trials,RCT)of the relevant literature,according to the strict into and extract the exclusion criteria included in the documents and data,Finally,RevMan5.4 software was used to summarize and analyze the data.Results:Results of Meta-analysis:Meta-analysis was performed in five aspects:recommended dose of romozumab,romozumab vs other drugs,risk of fracture,total adverse reactions and severe adverse reactions.Among them,the analysis results of the dose of romozumab showed that when the dose of romozumab was 210mg compared with placebo,the BMD changes in the lumbar spine,femoral neck and total hip were the most significant,which was consistent with the results of McClung[11]and Ishibashl[6].Therefore,the subcutaneous injection dose of 210mg/month was recommended for the treatment of osteoporosis.However,in the lumbar BMD forest map,romozumab 210mg or 140mgVS placebo showed heterogeneity.50%showed obvious heterogeneity.We found the source of heterogeneity through sensitivity analysis and subgroup analysis,and determined that the regional study was the source of heterogeneity.In a meta-analysis of romozumab versus other agents,romozumab was more effective than alendronate or teripartide in improving BMD in the lumbar spine,femoral neck,and total hip,and was statistically significant(P<0.05).In terms of fracture risk,the risk of new vertebral fractures after 12 months of treatment was lower than in the control group,but there was no statistically significant difference in hip fractures.However,after 24 months of treatment,the risk of new vertebral and hip fractures was significantly lower than in the control group.In terms of total adverse reactions and serious adverse reactions,there was almost no significant difference between the romozumab test group and the control group.However,in the subgroup analysis of total adverse reactions,the difference between romozumab 210mg and alendronate sodium 70mg was statistically significant[OR=0.86,95%CI(0.74,0.99),P=0.03],but the difference was not obvious.Conclusions:Studies have shown that romozumab single therapeutic dose resistance at 210 mg improve bone mineral density effect is best,romozumab sheet resistance with Allen phosphonic acid sodium,tenet peptide drugs,increase bone density effect is more significant,and romozumab sheet resistance can significantly reduce the risk of bone fractures,in terms of total adverse reactions and the serious adverse reactions and the rest of the drugs did not have obvious difference,show romozumab single drug resistant safe and reliable.