| Objective To assess the efficacy and safety of different pharmacological anti-osteoporosis drugs that are indicated for the prevention of osteoporotic fractures in postmenopausal women through conducting a network meta-analysis. Methods The randomized controlled trials (RCTs) were screened by searching the Chinese and English databases up to March2019. After selection and evaluation of the risk of bias,the data were analyzed using R Studio and Stata software. Results A total of 37 RCTs with 16 inventions, which involved 83907 patients, were included in the network meta-analysis. The results showed that the efficacy of all the interventions were better in preventing new vertebral fractures than the placebo. Among those, abalopeptide (OR=0.12, 95% CI: 0.04-0.35), teriparatide (OR=0.24, 95% CI: 0.16-0.35), zoledronic acid (OR=0.28, 95% CI: 0.18-0.43), and romosozumab (OR=0.30, 95% CI: 0.19-0.45) had the most significant effect. The order of the four inventions ranking from good to bad was abalopeptide>teriparatide>zoledronic acid>romosozumab, according to the SUCRA result. Abalopeptide (OR=0.46, 95% CI: 0.21-0.97), teriparatide (OR=0.54, 95% CI: 0.39-0.75), romosozumab (OR=0.62, 95% CI: 0.44-0.90), and risedronate (OR=0.70, 95% CI: 0.50-0.97) were better than placebo in preventing non-vertebral fractures. The order of the four inventions ranking from good to bad was abalopeptide>teriparatide>romosozumab>risedronate according to the SUCRA result. Except for rhPTH(1-31), no statistical difference was observed in the rate of adverse effect between each of the rest inventions and placebo, which showed a favorable safety profile. Conclusion Abalopeptide, teriparatide, zoledronic acid, and romosozumab show more effectiveness and safety in preventing the osteoporotic fracture in postmenopausal women. |