Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
To assess the relative efficacy of abaloparatide compared with other osteoporosis treatment options (alendronate, denosumab, ibandronate, raloxifene, risedronate, romosozumab, strontium ranelate, teriparatide, zoledronic acid).
PubMed®, Embase® and Cochrane Central Register of Controlled Trials were searched for all randomized controlled trials published prior to December 20, 2017 including postmenopausal osteoporotic women (PMO) with and without prior fractures. Selection of trials for inclusion in the network meta-analysis (NMA) was based on populations (inclusion/exclusion criteria), interventions (dose/frequency), and outcomes (fracture assessment). NMA was conducted by fracture sites with relative risk (RR) of fractures as the main clinical endpoint.
For vertebral fractures (VF) and nonvertebral fractures (NVF), 18 studies informed a network of 11 treatments and 21 studies informed a network of 11 treatments, respectively. For VF, abaloparatide had the greatest effect relative to placebo (RR 0.13; 95% CrI: 0.04-0.34) with estimates ranging from 0.27 for teriparatide to 0.71 for strontium ranelate. For NVF, abaloparatide had a greater risk reduction versus placebo (RR 0.50; 95% CrI: 0.28-0.85) and most effective (with a probability of 0.70) versus teriparatide (RR 0.62; 95% CrI: 0.47-0.82) and romosozumab (RR 0.64; 95% CrI: 0.49-0.81). In a further evaluation of specific fracture sites, 10 studies reporting wrist fractures informed a network of 8 treatments. Abaloparatide was associated with the greatest effect versus placebo (RR 0.39; CrI: 0.15- 0.90) and reduced the risk of fractures versus teriparatide (RR 0.45; CrI: 0.17-1.03) and denosumab (RR 0.47; CrI: 0.18-1.12). The NMA illustrated a good level of agreement with the direct trial evidence and direct pairwise comparisons.
Based on the current NMA, abaloparatide treatment resulted in a greater reduction in RR of both vertebral and nonvertebral fractures in PMO versus placebo in comparison with other treatment options. Generalizability is limited to the trials’ population included in the NMA.
To cite this abstract in AMA style:Reginster JY, Bianic F, Campbell R, Martin M, Williams SA, Fitzpatrick LA. Abaloparatide for Risk Reduction of Nonvertebral and Vertebral Fractures in Postmenopausal Women with Osteoporosis: A Network Meta-Analysis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/abaloparatide-for-risk-reduction-of-nonvertebral-and-vertebral-fractures-in-postmenopausal-women-with-osteoporosis-a-network-meta-analysis/. Accessed January 24, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/abaloparatide-for-risk-reduction-of-nonvertebral-and-vertebral-fractures-in-postmenopausal-women-with-osteoporosis-a-network-meta-analysis/