Summary Within this meta-analysis of all Merck-conducted, placebo-controlled clinical trials of alendronate, the occurrence of AF was uncommon, with most studies reporting two or fewer events. assessment of this nature. Consequently, only relative risks and 95% CIs are reported. Results Forty-one studies were regarded as for the meta-analysis. Thirty-two studies met all criteria for inclusion in the analysis, including having alendronate participant organizations within the pre-specified dose range for alendronate (Table?1). The 32 studies represent 9,518 participants and 20,265 person-years on alendronate, with an average of 2.13 person-years per subject, and 7,773 participants and 18,018 person-years on placebo, with an average of 2.32 person-years per subject. Follow-up time ranged from 12?weeks for Studies 162 and 904 to 6?years for study 055. Endpoint of atrial fibrillation or atrial flutter All AF events (atrial fibrillation and atrial flutter) The value for the test for heterogeneity was 0.30 based on the treatment-by-study connection term in the Poisson regression model. The estimated relative risk for those events of AF (severe and nonserious combined) was 1.16 (95% CI?=?0.87, 1.55; value for the test for heterogeneity was 0.13 based on the treatment-by-study connection term in the Poisson regression magic size. The estimated relative risk for AF SAEs was 1.25 (95% CI?=?0.82, 1.93; shows that there have Terbinafine hydrochloride manufacture been no AF occasions in the placebo arm from the scholarly research, although there might have been a meeting in the alendronate … Various Terbinafine hydrochloride manufacture other endpoints The endpoints of CA, CVA, and CHF had been analyzed in the meta-analysis using the same research as well as the same individual populations as had been employed for the atrial fibrillation endpoint: 32 studies including 9,518 individuals on alendronate and 7,773 on placebo. Cardiac arrhythmias The approximated relative risk for any AEs of cardiac arrhythmia (including AF) was 0.92 (95% CI?=?0.79, 1.07; p?=?0.31), as well as the estimated chances proportion was 0.91 (95% CI?=?0.78, 1.06; p?=?0.23). The approximated comparative risk for SAEs was 1.18 (95% CI?=?0.87, 1.61; p?=?0.31), as well as the estimated odds percentage was 1.17 (95% Terbinafine hydrochloride manufacture CI?=?0.87, 1.59; GDF7 p?=?0.30). There were 360 AEs and 98 SAEs of cardiac arrhythmia for alendronate, happening in 26 tests (Online Table?A). There were 346 AEs and 78 SAEs of cardiac arrhythmia for placebo, happening in 24 tests. Thirty tests experienced at least one event in either treatment group; two tests had no events. As seen with the AF endpoint, Match accounted for two thirds of the arrhythmia events (study 51.1alendronate?=?85, placebo?=?78, RR?=?1.06; study 51.2alendronate?=?159, placebo?=?162, RR?=?0.99). Non-hemorrhagic cerebrovascular incidents (CVA) The estimated relative risk for those CVA AEs was 0.85 (95% CI?=?0.65, 1.11; p?=?0.25), and the estimated odds percentage was 0.84 (95% CI?=?0.65, Terbinafine hydrochloride manufacture 1.10; p?=?0.21). There were 108 CVA AEs for alendronate happening in 11 tests, compared with 122 CVA AEs for placebo happening in nine tests (Online Table?A). Thirteen tests experienced CVA AEs; 19 tests experienced no CVA events. Congestive heart failure (CHF) The estimated relative risk for those CHF AEs was 0.96 (95% CI?=?0.71, 1.30; p?=?0.84), and the estimated odds percentage was 0.95 (95% CI?=?0.71, 1.28; p?=?0.75). There were 91 CHF AEs for alendronate happening in 11 tests compared with 91 AEs for placebo happening in eight tests (Online Table?A). Thirteen tests experienced an AE in one or both treatment organizations; 19 tests experienced no CHF events. Myocardial infarctions and cardiovascular deaths in Match As Match was the largest trial included in this meta-analysis and as it was the only trial.