Health and adverse events associated with extended oral bisphosphonates among postmenopausal women: a systematic review.

However, benefits and risks of extending oBP therapy beyond this duration remain uncertain.

然而，延长oBP治疗时间超过此期限的益处和风险仍然不确定。

aim

To determine the health outcomes (bone mineral density [BMD], fracture risk) and adverse effects (atypical fracture, osteonecrosis of the jaw [ONJ]) of extended oBP therapy beyond 5 years among postmenopausal women.

确定延长使用骨质疏松症治疗药物（骨密度[BMD]，骨折风险）和不良反应（非典型骨折，颌骨坏死[ONJ]）在绝经后妇女中超过5年的健康结果。

methodology

A systematic search of Medline©, EMBASE©, and CINAHL© was conducted from inception to 15 March 2024.

从创刊至2024年3月15日，对Medline©、EMBASE©和CINAHL©进行了系统检索。

Interventional and observational studies published in English were included.

包括了发表在英文期刊上的干预性和观察性研究。

Two authors independently performed screening, quality appraisal using the NIH Quality Appraisal tool, and data extraction.

两位作者独立进行了筛选、使用NIH质量评估工具进行质量评价以及数据提取。

The review followed PRISMA guidelines and was registered on PROSPERO (CRD42024475332).

本综述遵循PRISMA指南，并已在PROSPERO上注册（CRD42024475332）。

High heterogeneity precluded meta-analysis.

高度的异质性使得无法进行荟萃分析。

Results

Eleven studies (4 controlled trials, 7 observational) were included: 3 rated as good quality, 7 as fair, and 1 as poor.

纳入了11项研究（4项对照试验，7项观察性研究）：其中3项被评为良好质量，7项评为一般质量，1项评为差质量。

Extended oBP therapy beyond 5 years increased BMD at the hip (3/3 studies), femoral neck (3/3 studies) and lumbar spine (5/5 studies).

超过5年的延长oBP治疗增加了髋部（3/3研究）、股骨颈（3/3研究）和腰椎（5/5研究）的骨密度（BMD）。

Prolonged oBP use reduced clinical vertebral fracture risk (1/6 studies) but increased the risk of atypical fractures (3/3 studies) and incomplete atypical femoral fractures (1/1 study).

长期使用oBP降低了临床椎体骨折风险（1/6项研究），但增加了非典型骨折（3/3项研究）和不完全非典型股骨骨折（1/1项研究）的风险。

None of the included studies assessed or reported ONJ.

所纳入的研究中没有一项评估或报告ONJ。

Conclusions

Substantial heterogeneity and limited high-quality evidence preclude definitive conclusions regarding extended oBP use in postmenopausal women.

显著的异质性和有限的高质量证据阻止了关于延长使用骨质疏松药物（oBP）在绝经后妇女中的明确结论。

While extended treatment may improve bone density and reduce vertebral fractures, it could also increase atypical fractures.

尽管延长治疗可能改善骨密度并减少椎体骨折，但它也可能增加非典型骨折。

Future high-quality studies are required to inform decisions regarding optimal treatment duration.

需要未来高质量的研究来指导关于最佳治疗持续时间的决策。