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

Su S, He N, Men P, Song C, Zhai S · Osteoporosis International

Pooling everything: MK-4 lowered the undercarboxylated-to-total osteocalcin ratio by 21.78 percentage points and raised lumbar bone density by 0.05 g/cm2 versus placebo, but the vertebral-fracture reduction was not significant (RR 0.87, 95% CI 0.64-1.20), and MK-4 increased adverse events (RR 1.47) and adverse drug reactions (RR 1.29).

Population

8,882 patients across 18 randomised trials of menatetrenone for osteoporosis

Intervention

Menatetrenone (MK-4), usually 45 mg/day

Comparator

Placebo or other anti-osteoporosis drugs

Limitations

Dominated by Japanese trials of MK-4 at 45 mg/day, several open-label; the BMD estimate rests on five small studies; says nothing about MK-7 at microgram doses.