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International Journal of Endocrinology
Volume 2014, Article ID 796510, 16 pages
http://dx.doi.org/10.1155/2014/796510
Review Article

Alendronate versus Raloxifene for Postmenopausal Women: A Meta-Analysis of Seven Head-to-Head Randomized Controlled Trials

1Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China
2Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19014, USA
3Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA 19102, USA

Received 14 May 2013; Accepted 31 October 2013; Published 5 January 2014

Academic Editor: Faustino R. Pérez-López

Copyright © 2014 Tiao Lin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. The aim of this study was to directly compare the efficacy and the safety of the two agents for postmenopausal women. Methods/Principal Findings. Electronic databases were searched for relevant articles that met our predefined inclusion criteria. Seven randomized controlled trials (RCTs) involving 4054 women were identified and included. Although Aln was more effective than Rlx in increasing bone mineral density (BMD), no statistical differences were observed in reducing the risk of neither vertebral fractures ( ) nor nonvertebral fractures ( ) up to two-year followup. Aln reduced the risk of vasomotor ( ) but increased the risk of diarrhea compared to Rlx ( ). Our subgroup analysis further indicated the difference between Aln and Rlx in fracture risk and was not materially altered by the administration pattern, the age. The weekly strategy of Aln would further reduce the upper gastrointestinal (GI) disorders and might gain more bone mass increment at lumbar spine compared to its daily treatment. Conclusion. There was no evidence of difference of fracture risk reduction between Aln and Rlx. In addition, age did not obviously influence their relative antifracture efficacy. For Aln the weekly strategy would further reduce the upper GI disorders and gain more bone mass increment compared to the daily treatment. During clinical decision making, the patients’ adherence and the related side-effects associated with both drugs should also be taken into account.