Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for management of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density.This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis.

Background: Osteoporosis is a significant concern, especially for individuals undergoing renal transplantation, as it disrupts bone health and increases the risk of fractures. Interventions for osteoporosis aim to address bone-related challenges in patients with renal transplantation, yet concerns persist regarding both efficacy and potential adverse events. Materials and Methods: We searched PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL databases until December 15, 2023, seeking studies that evaluated the efficacy and adverse events of osteoporosis medications in patients with renal transplantation. The Cochrane tool was utilized to assess the quality of the studies. The statistical analysis was performed using Comprehensive Meta-Analysis software, version 3. 0. Results: We enrolled 594 participants from 7 randomized controlled trials. Combining trial results reveals that using anti-osteoporotic agents (IBANDRONATE, Risedronate, and Pamidronate) reduces the risk of vertebral fractures compared to the placebo. However, the reduction was not statistically significant (OR: 0. 49, CI 95%: 0. 20-1. 22). Additionally, lumbar spine, femoral neck, and total hip BMD showed no significant differences between anti-osteoporotic agents (Denosumab, Zoledronic acid, IBANDRONATE, Risedronate, and Pamidronate) and placebo. Moreover, there were no significant differences in adverse events between the interventions and placebo. Conclusion: The study suggests that anti-osteoporotic agents in renal transplantation patients may be associated with a non-significant lower risk of vertebral fractures compared to a placebo. Findings also indicate no significant differences in adverse events between interventions and placebos. Caution is advised in interpreting these results due to the absence of statistically significant differences, emphasizing the need for further research to enhance our understanding of efficacy and safety in renal transplantation

Background: We aimed to review the systematic economic evaluation of denosumab versus than alternative drugs and oral bisphosphonates of postmenopausal osteoporosis in women and help health system policy makers for prioritizing and optimally allocate limited health resources. Methods: We examined the databases of PubMed, Web of Science, Embase, Scopus, Cochrane Library, ProQuest. Strategy search was designed based on keywords. Inclusion criteria were: studies that conducted economic evaluation denosumab compared to oral bisphosphonates for the treatment of osteoporosis in postmenopausal women. Cost-effectiveness studies conducted using decision analysis models based on the economic evaluation approach,studies with available full-text papers,and studies written in English and published between 2010 and 2020. After selecting articles based on inclusion and exclusion criteria, data were extracted and the results were summarized. The quality of the articles was evaluated using the CHEERS checklist. Results: Among 214 initial studies, 8 studies met the inclusion criteria. Most studies focused on the costeffectiveness of denosumab compared with oral bisphosphonates for the treatment of osteoporosis. The study agreed interval ranged from 3 months to 5 years. The costs investigated in the studies were direct medical costs. In most studies, the use of denosumab significantly prevented fractures. Conclusion: Denosumab is generally more cost-effective than alternative drugs and oral bisphosphonates (alendronate, risedronate, strontium ranelate, IBANDRONATE, and untreated).

Despite widespread research on non-traumatic femoral head osteonecrosis (FHON), there is no consensus about preventative treatment options. Insufficient blood supply and increased intra-osseous pressure are the initiating events in the majority of cases. BMPs are growth factors that belong to the transforming growth factor β (TGFβ ) superfamily. Two specific formulations of BMPs have already been approved by the FDA: 1. BMP-2 (Infused, Medtronic) for the treatment of tibial open fractures and spinal fusion; 2. BMP-7 (OP-1, Stryker) in the setting of long bone non-unions. To our knowledge there is no published work reviewing the utility of BMP-2 in the setting of FHON. Online databases (EMBASE, Cochrane, MEDLINE and PubMed) for literature relating to the use of BMP-2 in the treatment of FHON on 2nd June 2017. Animal studies: A total of 169 animal subjects with induced FHON were treated with BMP-2 in all the included in vivo studies. Improved histological parameters, areas of revascularization, areas of new bone formation and osteoid deposition were seen in all studies. The number of osteoclasts decreased post operatively, in the IBANDRONATE and BMP-2 group. Human studies: In combination, 96 human hips were treated in two studies utilizing BMP-2 and mean follow-up was at least five years. Success rate of BMP-2 was above 80 % (based on Harris score and WOMAC score) in both studies. Both are level III studies. The present review of animal and clinical studies could not find well-designed prospective comparable studies with large sample size and preliminary evidence is not sufficient to supports the utilization of BMP-2, and its impact on the midterm outcomes of FHON.