Influence of bisphosphonate pretreatment on bone mineral density gains and fracture outcomes with teriparatide: A systematic review and meta-analysis
Pooled result · % change in lumbar spine BMD with teriparatideResult — go to the resultMD −2.21 % 95% CI −4.17,−0.25Authors' conclusion
Prior bisphosphonate exposure is associated with modest, site-specific attenuation of lumbar spine BMD gains with teriparatide, without significant effects at non-spinal sites.
Study context
- Population
- Individuals with osteoporosis treated with teriparatide; randomised trials, non-randomised trials, observational studies and post hoc or subgroup analyses15 studies
- Participants
- 8,763 vs 7,071
- Comparison
- Bisphosphonate (BP)-pretreated vs BP-naïve individuals receiving teriparatide
- BP-pretreatedn = 8,763
- BP-naïven = 7,071reference
- Outcome
- % change in lumbar spine BMD with teriparatide
Methodological detailsrandom-effects models with Hartung-Knapp adjustment, PRISMA
- Random-effects models with Hartung-Knapp adjustment
- PRISMA
Pooled result
As reported in the abstract
MD
−2.21 %
95% CI −4.17,−0.25
P = 0.027
BP-pretreatedvs BP-naïve
MD −2.21 % (95% CI −4.17,−0.25); P = 0.027
Further pooled results
| Outcome | Estimate | P value | |
|---|---|---|---|
| Incident fracturesBP-pretreatedvs BP-naïvePooling of absolute fracture events · adjusted analyses based on only two studies | OR 1.43 (95% CI 1.09,1.88) | P = 0.009 | |
| Incident fracturesBP-pretreatedvs BP-naïvePooled adjusted HRs; not statistically significant · adjusted analyses based on only two studies | HR 1.35 (95% CI 0.99,1.83) | P = 0.055 | |
| 0.512Ratio (log scale) |
% change in hip bone mineral density (BMD) after teriparatide
- No significant difference
% change in femoral neck BMD after teriparatide
- No significant difference
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Influence of bisphosphonate pretreatment on bone mineral density gains and fracture outcomes with teriparatide: A systematic review and meta-analysis. Osteoporos Int. Published 15 July 2026. doi:10.
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