Andrea Messori1, Valeria Fadda2, Dario Maratea2, Sabrina Trippoli2, Claudio Marinai3. 1. HTA Unit, Area Vasta Centro Toscana Regional Health System, Via San Salvi 12, 50100, Florence, Italy. andrea.messori.it@gmail.com. 2. HTA Unit, Area Vasta Centro Toscana Regional Health System, Via San Salvi 12, 50100, Florence, Italy. 3. Department of Pharmaceutical Logistics, ESTAV Toscana Centro, Regional Health Service, 50100, Florence, Italy.
Abstract
BACKGROUND: In the present study, we undertook an equivalence analysis on the effectiveness of the main anti-reabsorptive agents indicated for women with osteoporosis. METHODS: Our methodology was a combination of meta-analysis (both pair-wise meta-analysis and network meta-analysis) and equivalence testing. The end-point was the incidence on new vertebral fractures. The anti-reabsorptive agents examined included alendronate, zoledronate, ibandronate, risedronate, and denosumab. RESULTS: Our analysis involved nine randomized trials. Ten head-to-head indirect comparisons were examined through network meta-analysis and the respective values of RR were estimated. The 95 % confidence intervals for RR remained within the interval of a relative ±40 % variation for all comparisons that involved alendronate, risedronate, ibandronate, and denosumab. In contrast, the comparisons involving zoledronate satisfied a post hoc margin up to ±67 %. CONCLUSION: Our results confirm that most of these anti-reabsorptive drugs (namely, alendronate, risedronate, ibandronate, and denosumab) are equivalent according to reasonable equivalence margins.
BACKGROUND: In the present study, we undertook an equivalence analysis on the effectiveness of the main anti-reabsorptive agents indicated for women with osteoporosis. METHODS: Our methodology was a combination of meta-analysis (both pair-wise meta-analysis and network meta-analysis) and equivalence testing. The end-point was the incidence on new vertebral fractures. The anti-reabsorptive agents examined included alendronate, zoledronate, ibandronate, risedronate, and denosumab. RESULTS: Our analysis involved nine randomized trials. Ten head-to-head indirect comparisons were examined through network meta-analysis and the respective values of RR were estimated. The 95 % confidence intervals for RR remained within the interval of a relative ±40 % variation for all comparisons that involved alendronate, risedronate, ibandronate, and denosumab. In contrast, the comparisons involving zoledronate satisfied a post hoc margin up to ±67 %. CONCLUSION: Our results confirm that most of these anti-reabsorptive drugs (namely, alendronate, risedronate, ibandronate, and denosumab) are equivalent according to reasonable equivalence margins.
Authors: Paul W Jones; Kai M Beeh; Kenneth R Chapman; Marc Decramer; Donald A Mahler; Jadwiga A Wedzicha Journal: Am J Respir Crit Care Med Date: 2014-02-01 Impact factor: 21.405