Effects of Bazedoxifene on Bone Mineral Density and Fracture in Post-Menopausal Osteoporotic Women: a Systematic Review and Meta-Analysis

Bazedoxifene (BZA) is a selective estrogen receptor modulator that reduces the risk of fracture and improves bone mineral density in post-menopausal women with osteoporosis. The aim of the present systematic review and meta-analysis was to investigate effects of BZA on bone mineral density (BMD) and fracture in post-menopausal osteoporotic women. We searched PubMed, Cochrane Central Register of Controlled Trials, Web of Sciences, Embase, and Scopus from until November 30, 2016. All randomized controlled trials that compared the effects of BZA on BMD and the incidence of vertebral and non-vertebral fractures in post-menopausal osteoporotic women compared with a control group were eligible for inclusion. Meta-analyses were conducted to calculate relative risk (RR) with 95% confidence interval (CI) for the association of BZA and vertebral and non-vertebral fractures compared with placebo. Nine randomized clinical trials met our inclusion criteria. Studies results showed that BZA significantly improves BMD, although we were not able to pool the results. Meta-analysis showed that the pooled effect of BZD on vertebral fracture was protective and significant (RR = 0.63; 95% CI 0.48, 0.83; P = 0.001). But pooled results did not show any association between taking BZD and the incidence of non-vertebral fracture (RR = 0.97; 95% CI 0.83, 1.13; P = 0.683). Evidence suggests that bazedoxifene is generally effective and safe in preventing bone loss and vertebral fracture in post-menopausal women with osteoporosis.