Tabriz University of Medical Sciences BioImpacts 2228-5652 16 1 2026 01 04 Bioavailability enhancement of alendronate by novel drug delivery systems: A systematic review and meta-analysis 32620 32620 10.34172/bi.32620 EN Sharifeh Khatib https://orcid.org/0009-0000-6298-009X Sara Roomizadeh https://orcid.org/0009-0002-5043-2066 Ladan Dayani https://orcid.org/0000-0001-9931-4664 Awat Feizi https://orcid.org/0000-0002-1930-0340 Saba Shahparyan https://orcid.org/0009-0003-8246-641X Sayed Abolfazl Mostafavi https://orcid.org/0000-0002-6505-5112 Journal Article 10.34172/bi.32620 2025 07 30 2026 07 19 Introduction: Osteoporosis is characterized by reduced bone mineral density and an increased risk of fractures, resulting in substantial healthcare costs and higher mortality. Bisphosphonates, such as alendronate, effectively treat osteoporosis by inhibiting bone resorption; however, their limited oral bioavailability restricts therapeutic efficacy. This study aims to evaluate different strategies developed to enhance the oral bioavailability of alendronate. Methods: A comprehensive literature search was performed across multiple databases without language or publication date restrictions, using a predefined search strategy. Two independent reviewers screened and selected eligible studies according to predetermined inclusion and exclusion criteria. The inclusion criteria comprised in vivo animal studies investigating the pharmacokinetics of alendronate formulations, focusing on bioavailability. Studies lacking essential pharmacokinetic data were excluded. Extracted data included pharmacokinetic parameters such as Cmax, Tmax, AUC₀–t, AUC₀–∞, and bioavailability, along with study characteristics, drug properties, animal details, and formulation specifics. Discrepancies in data extraction were resolved through discussion and consensus between reviewers. Results: Meta-analyses revealed significant differences in AUC₀–∞ and bioavailability between novel drug delivery systems (NDDS) and the pure drug (P < 0.05), while no significant differences were observed in Cmax and Tmax (P > 0.05). Conclusion: The drug delivery systems evaluated in this review demonstrated a marked influence on pharmacokinetic parameters and enhancement of bioavailability. These findings suggest that the use of NDDS may improve the bioavailability and therapeutic effectiveness of alendronate.