Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians
An erratum to this article was published (Ann Intern Med, Jun 2023 ↗)
Authors' conclusion
Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab, followed by alendronate, reduce clinical fractures in postmenopausal females with osteoporosis. Abaloparatide and teriparatide increased WAEs; longer duration bisphosphonate use may increase AFF and ONJ risk though these events were rare.
Study context
- Population
- Adults receiving eligible interventions for low bone mass or osteoporosis; Randomized controlled trials (RCTs) for fracture outcomes, RCTs and large observational studies (n ≥1000) for harms; 2014 through February 202234 RCTs and 36 observational studies
- Comparison
- Low bone mass and osteoporosis treatments to prevent fractures
- Outcome
- Fractures
Methodological detailsdual independent risk of bias and certainty of evidence assessment, Abstracted by 1 reviewer and verified by a second
- Dual independent risk of bias and certainty of evidence assessment
- Abstracted by 1 reviewer and verified by a second
Pooled result
As reported in the abstract
- Bisphosphonates and denosumab reduced hip, clinical and radiographic vertebral, and other clinical fractures in postmenopausal females with osteoporosis (moderate to high certainty of evidence (CoE))
- Abaloparatide and teriparatide reduced clinical and radiographic vertebral fractures (moderate to high CoE)
- Raloxifene and bazedoxifene for ≥36 months reduced radiographic vertebral but not clinical fractures (low to moderate CoE)
- Abaloparatide, teriparatide, and sequential romosozumab then alendronate may be more effective than bisphosphonates in reducing clinical fractures for 17 to 24 months in older postmenopausal females at very high fracture risk (low to moderate CoE)
Further pooled results
Fractures in older females with low bone mass and in males with osteoporosis (subgroups)
- Bisphosphonates may reduce clinical fractures in older females with low bone mass (low CoE)
- Bisphosphonates may reduce radiographic vertebral fractures in males with osteoporosis (low to moderate CoE)
Original publication
Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians. Ann Intern Med. Published 3 January 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →