The efficacy and safety of menatetrenone in the management of osteoporosis: a systematic review and meta-analysis of randomized controlled trials

Abstract

SummaryIn our systematic review and meta-analysis, we comprehensively evaluated menatetrenone in the management of osteoporosis. We found that menatetrenone decreased the ratio of undercarboxylated osteocalcin to osteocalcin (ucOC/OC) and improved lumbar BMD compared with placebo based on the 18 studies assessed. However, its benefit in fracture risk control was uncertain.IntroductionWe performed a systematic review and meta-analysis of the efficacy and safety of menatetrenone in managing osteoporosis.MethodsPubMed, Cochrane Library, Embase, ClinicalTrials.gov, and three Chinese literature databases (CNKI, CBM, Wanfang) were searched for relevant randomized controlled trials (RCTs) published before October 5, 2017, comparing menatetrenone with other anti-osteoporotic drugs or placebo in treating osteoporosis. The pooled risk ratio (RR) or mean difference (MD) and 95% confidence interval (CI) were calculated using fixed-effects or random-effects meta-analysis.ResultsEighteen RCTs (8882 patients) were included. Pooled analyses showed that menatetrenone was more effective than placebo in improving lumbar bone mineral density (BMD) (five studies, N\u2009=\u2009658, MD\u2009=\u20090.05\xa0g/cm2, 95% CI 0.01 to 0.09\xa0g/cm2) and decreasing ucOC/OC (two studies, N\u2009=\u200975, MD\u2009=\u2009−\u200921.78%, 95% CI −\u200933.68 to −\u20099.87%). Compared with placebo, menatetrenone was associated with a nonsignificantly decreased risk of vertebral fracture (five studies, N\u2009=\u20095508, RR\u2009=\u20090.87, 95% CI 0.64 to 1.20). Evidence on other anti-osteoporotic drugs as comparators was limited and revealed no significantly different effects of menatetrenone on BMD or fracture risks. Furthermore, compared with placebo, menatetrenone significantly increased the incidence of adverse events (AEs) (two studies, N\u2009=\u20091949, RR\u2009=\u20091.47, 95% CI 1.07 to 2.02) and adverse drug reactions (four studies, N\u2009=\u20096102, RR\u2009=\u20091.29, 95% CI 1.07 to 1.56). However, no significant difference in the incidence of serious AEs was found between menatetrenone and placebo.ConclusionsMenatetrenone significantly decreases ucOC and might improve lumbar BMD in osteoporotic patients. However, its benefit in fracture risk control is uncertain.