TY - JOUR
T1 - Pharmacological agents for bone fracture healing
T2 - talking points from recent clinical trials
AU - Migliorini, Filippo
AU - Cocconi, Federico
AU - Vecchio, Gianluca
AU - Schäefer, Luise
AU - Koettnitz, Julian
AU - Maffulli, Nicola
N1 - Lerh-KH Academic Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medical University, Bolzano, Italy
PY - 2023
Y1 - 2023
N2 - INTRODUCTION: Pharmacological strategies might influence bone healing in terms of time to union or quality of mature bone. This expert opinion discussed the current level I evidence on the experimental pharmacological agents used to favor bone fracture healing.AREAS COVERED: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In April 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, Embase. All the randomized clinical trials investigating pharmacological agents for bone fracture healing were accessed. No time constraint was set for the search. The search was restricted to RCTs. No additional filters were used in the database search. Data from 19 RCTs (4067 patients) were collected. 78% (3160 of 4067) were women. The mean length of the follow-up was 9.3 months (range, 1-26 months). The mean age of the patients was 64.4 years (range, 8-84 years).EXPERT OPINION: Calcitonin could favor bone fracture healing. Bisphosphonates (alendronate, zoledronate, clodronate), monoclonal antibodies (denosumab, romosozumab), statins, vitamin D and calcium supplementation, strontium ranelate, and ibuprofen did not influence bony healing. Concerning the effect of parathormone, current level I evidence is controversial, and additional studies are required.LEVEL OF EVIDENCE: Level I, systematic review of RCTs.
AB - INTRODUCTION: Pharmacological strategies might influence bone healing in terms of time to union or quality of mature bone. This expert opinion discussed the current level I evidence on the experimental pharmacological agents used to favor bone fracture healing.AREAS COVERED: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In April 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, Embase. All the randomized clinical trials investigating pharmacological agents for bone fracture healing were accessed. No time constraint was set for the search. The search was restricted to RCTs. No additional filters were used in the database search. Data from 19 RCTs (4067 patients) were collected. 78% (3160 of 4067) were women. The mean length of the follow-up was 9.3 months (range, 1-26 months). The mean age of the patients was 64.4 years (range, 8-84 years).EXPERT OPINION: Calcitonin could favor bone fracture healing. Bisphosphonates (alendronate, zoledronate, clodronate), monoclonal antibodies (denosumab, romosozumab), statins, vitamin D and calcium supplementation, strontium ranelate, and ibuprofen did not influence bony healing. Concerning the effect of parathormone, current level I evidence is controversial, and additional studies are required.LEVEL OF EVIDENCE: Level I, systematic review of RCTs.
KW - Humans
KW - Female
KW - Child
KW - Adolescent
KW - Young Adult
KW - Adult
KW - Middle Aged
KW - Aged
KW - Aged, 80 and over
KW - Male
KW - Fracture Healing
KW - Bone Density Conservation Agents
KW - Diphosphonates/pharmacology
KW - Alendronate/pharmacology
KW - Vitamin D/pharmacology
U2 - 10.1080/13543784.2023.2263352
DO - 10.1080/13543784.2023.2263352
M3 - Review article
C2 - 37740660
SN - 1354-3784
VL - 32
SP - 855
EP - 865
JO - EXPERT OPINION ON INVESTIGATIONAL DRUGS
JF - EXPERT OPINION ON INVESTIGATIONAL DRUGS
IS - 9
ER -