ABSTRACT
Objective To systematically evaluate the efficacy of alendronate on the primary and secondary preventions of osteoporotic fractures in postmenopausal women.Methods Literatures and related references were searched from MEDLINE (from 1966 to April 2011),Embase (from 1966to April 2011),Cochrane Library (the second Issue,2011),CBM disc,CNKI,WANFANG and VIP database by Cochrane systematical evaluation.All related randomized controlled trials were collected,and Meta analysis was performed by RevMan 5.0 soft ware provided by Cochrane collaboration.Results Totally 11 randomized controlled trials were evaluated.Meta-analysis showed that 10 mg oral alendronate daily for secondary prevention could reduce the incidence of spine,hip,wrist and non vertebra fractures (RR 0.57,95％ CI:0.49-0.67),but for the primary prevention,alendronate could not reduce the fracture incidence except for spine fracture (RR=0.55,95％CI:0.38-0.80).Adverse events associated with alendronate were not increased,and the sensitivity analysis results were not changed (RR =0.95,95％ CI:0.83-1.09).Conclusions Alendronate can reduce osteoporotic fractures in postmenopausal women for the secondary prevention,but the effect of alendronate on osteoporotic fractures for the primary prevention needs further study.