Comparative efficacy between monoclonal antibodies and conventional drugs in postmenopausal women with osteoporosis: a network meta-analysis

BACKGROUND To evaluate the efficacy of different pharmacological interventions, with emphasis on monoclonal antibodies (McAbs) for the treatment of postmenopausal osteoporotic women. METHODS A search of PubMed, Google Scholar, Embase, and the Cochrane Library, as well as China National Knowledge Infrastructure (CNKI) was performed. Data were collected and pooled using Bayesian network meta-analysis (NMA), which conducts both direct and indirect comparisons. The primary outcome was the percentage change in bone mineral density (BMD) in the lumbar spine from baseline to 1 year of treatment. All drugs were ranked based on the surface under the cumulative ranking area (SUCRA). Furthermore, the heterogeneity, consistency, and publication bias of the enrolled literature were assessed. RESULTS There were 14 randomized controlled trials (RCTs) consisting of 4,881 participants included to compare 11 interventions. Compared with that of a placebo, all the 10 selected therapies showed significant efficacy through changes in BMD ranging from 6.0% to 19.0% (all P