On 2014 Jul 02, Valeria Fadda commented:

Gastrointestinal adverse events of bisphosphonates

Valeria Fadda HTA Unit, Area Vasta Centro Toscana, Regional Health System, Via San Salvi 12, 50100 Firenze (Italy)

In the paper by Tadrous et al. [1], the gastrointestinal safety of bisphosphonates in primary osteoporosis has been assessed. In particular, the safety end-point has been compared for individual agents (i.e. alendronate, zoledronate, risedronate or etidronate) versus placebo; some head-to-head comparisons between active agents were studied too. The original analysis by Tadrous et al. expressed these outcomes according to the outcome measure of odds-ratio (OR). However, since the outcome measure of risk difference (RD) is preferable for analyses aimed at equivalence testing, we have repeated the meta-analysis by Tadrous using RD in substitution for OR. Our results are shown in Figure S1.

Figure S1. Standard pair-wise meta-analysis of the incidence of gastrointestinal adverse events: Forest plot of risk differences for a series of comparisons involving alendronate, risedronate, etidronate, zoledronate, and placebo (data of 103 study arms from 51 randomized trials). The horizontal bars indicate the two-sided 95% confidence interval for RD of individual trials (solid squares) or of subgroup meta-analysis (yellow diamonds). Abbreviations: AE, adverse event; RD, risk difference; P, placebo; A, alendronate; R, risedronate; E, etidronate; Z, zoledronate; Ev, events; Trt, number of patients in the treatment groups; Ctrl, number of patients in the control groups.

This figure is available at url http://www.osservatorioinnovazione.net/papers/figures1fromtadrous.jpg

References

1. Tadrous M, Wong L, Mamdani MM, Juurlink DN, Krahn MD, Lévesque LE, Cadarette SM. Comparative gastrointestinal safety of bisphosphonates in primary osteoporosis: a network meta-analysis. Osteoporos Int. 2014 Apr;25(4):1225-35. doi: 10.1007/s00198-013-2576-2

On 2014 Jul 02, Valeria Fadda commented:

Gastrointestinal adverse events of bisphosphonates

Valeria Fadda HTA Unit, Area Vasta Centro Toscana, Regional Health System, Via San Salvi 12, 50100 Firenze (Italy)

In the paper by Tadrous et al. [1], the gastrointestinal safety of bisphosphonates in primary osteoporosis has been assessed. In particular, the safety end-point has been compared for individual agents (i.e. alendronate, zoledronate, risedronate or etidronate) versus placebo; some head-to-head comparisons between active agents were studied too. The original analysis by Tadrous et al. expressed these outcomes according to the outcome measure of odds-ratio (OR). However, since the outcome measure of risk difference (RD) is preferable for analyses aimed at equivalence testing, we have repeated the meta-analysis by Tadrous using RD in substitution for OR. Our results are shown in Figure S1.

Figure S1. Standard pair-wise meta-analysis of the incidence of gastrointestinal adverse events: Forest plot of risk differences for a series of comparisons involving alendronate, risedronate, etidronate, zoledronate, and placebo (data of 103 study arms from 51 randomized trials). The horizontal bars indicate the two-sided 95% confidence interval for RD of individual trials (solid squares) or of subgroup meta-analysis (yellow diamonds). Abbreviations: AE, adverse event; RD, risk difference; P, placebo; A, alendronate; R, risedronate; E, etidronate; Z, zoledronate; Ev, events; Trt, number of patients in the treatment groups; Ctrl, number of patients in the control groups.

This figure is available at url http://www.osservatorioinnovazione.net/papers/figures1fromtadrous.jpg

References

1. Tadrous M, Wong L, Mamdani MM, Juurlink DN, Krahn MD, Lévesque LE, Cadarette SM. Comparative gastrointestinal safety of bisphosphonates in primary osteoporosis: a network meta-analysis. Osteoporos Int. 2014 Apr;25(4):1225-35. doi: 10.1007/s00198-013-2576-2