Efficacy and safety profiles of manidipine compared with amlodipine: A meta-analysis of head-to-head trials

The aim of this meta-analysis was to compare the efficacy and safety profile of manidipine 20 mg with that of amlodipine 10 mg. A systematic research of quantitative data produced or published between 1995 and 2009 was performed. Head-to-head randomized controlled trials (RCTs) of 12 months minimum duration reporting comparative efficacy (changes in systolic and diastolic blood pressure) and safety (total adverse events and ankle oedema), were included. Four high-quality RCTs, accounting for 838 patients (436 received manidipine and 402 received amlodipine) were included. The effi cacy of manidipine and amlodipine was statistically equivalent: effect size for DBP =−0.08 (p = 0.22) and SBP =−0.01 (p =0.83).The global safety of manidipine was signifi cantly better than amlodipine: the relative risk (RR) for adverse event was 0.69 (0.56 – 0.85), and particularly for ankle oedema RR was 0.35 (0.22 – 0.54). Publication bias was not signifi cant and the robustness of the analyses was good. These data suggest a better efficacy/safety ratio of manidipine over amlodipine

Efficacy of D-Hormones in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate

peer reviewe

Efficacy of alphacalcidol and calcitriol in primary and corticosteroid-induced osteoporosis: a meta-analysis of their effects on bone mineral density and fracture rate

peer reviewe

A critical analysis of the efficacy of estrogens on spinal and non-spinal fracture reduction

peer reviewedDuring more than 20 years, estrogens replacement therapy (ERT) has been consistently regarded as the first choice for prevention of trabecular and cortical bone loss in postmenopausal women. However, there are more doubts upon the unequivocal demonstration of the anti-fracture efficacy of ERT, at the spine and hip. Controlled clinical trials and systematic reviews were retrieved, using Medline 1970-2002 and EMBASE 1980-2002. There is a convergent body of evidence that estrogens could significantly reduce the risk of vertebral and non-vertebral fractures, providing this treatment is started early after the menopause and pursued indefinitely. In the recent perspective of the published studies, reevaluating the non-skeletal benefits and harms of ERT in post-menopausal women, other chemical entities might be better options to be used for the specific purpose of preventing or treating post-menopausal osteoporosis