The DOI matches its Crossref record; 34 of the 35 references it cites were found in a registry or an index.
Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs
Abstract
Purpose To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis.Methods After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density.Results Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate.Conclusion Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The maximum total BMD loss has been previously estimated to be 69.0% relative to the astronauts’ pre-flight BMD [18], and obtained by combining data from different large studies in humans [23,24].”
From A human mission to Mars: Predicting the bone mineral density loss of astronauts (2020) · cites this paper as [23]
Citations
Cites
Black, D. M., Cummings, S. R., Karpf, D. B., Cauley, J. A., Thompson, D. E., Nevitt, M. C., Bauer, D. C., Genant, H. K., Haskell, W. L., Marcus, R., et al. (1996) · The Lancet · doi:10.1016/s0140-6736(96)07088-2 · Cited by 3,846
Self-citationMarshall, D., Johnell, O., & Wedel, H. (1996) · BMJ · doi:10.1136/bmj.312.7041.1254 · Cited by 3,709
Cummings, S. R. (1998) · JAMA · doi:10.1001/jama.280.24.2077 · Cited by 2,277
Self-citationLiberman, U. A., Weiss, S. R., Bröll, J., Minne, H. W., Quan, H., Bell, N. H., Rodriguez-Portales, J. A., Downs, R. W., Dequeker, J., Favus, M. J., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199511303332201 · Cited by 2,276
Self-citationReginster, J.-Y., Minne, H. W., Sorensen, O. H., Hooper, M., Roux, C., Brandi, M. L., Lund, B., Ethgen, D., Pack, S., Roumagnac, I., et al. (2000) · Osteoporosis International · doi:10.1007/s001980050010 · Cited by 1,580
Chesnut, C. H., Silverman, S., Andriano, K., Genant, H., Gimona, A., Harris, S., Kiel, D., LeBoff, M., Maricic, M., Miller, P., et al. (2000) · The American Journal of Medicine · doi:10.1016/s0002-9343(00)00490-3 · Cited by 1,122
Self-citationMarkers of bone resorption predict hip fracture in elderly women: The EPIDOS prospective study
Garnero, P., Hausherr, E., Chapuy, M. C., Marcelli, C., Grandjean, H., Müller, C., Cormier, C., Bréart, G., Meunier, P. J., & Delmas, P. D. (1996) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650111021 · Cited by 984
Intermittent Cyclical Etidronate Treatment of Postmenopausal Osteoporosis
Watts, N. B., Harris, S. T., Genant, H. K., Wasnich, R. D., Miller, P. D., Jackson, R. D., Licata, A. A., Ross, P. D., Woodson, G. C., Yanover, M., et al. (1990) · New England Journal of Medicine · doi:10.1056/nejm199007123230201 · Cited by 947
Self-citationStorm, T., Thamsborg, G., Steiniche, T., Genant, H. K., & Sørensen, O. H. (1990) · New England Journal of Medicine · doi:10.1056/nejm199005033221803 · Cited by 926
Self-citationMeta-Analysis, Decision Analysis, and Cost-Effectiveness Analysis
Petitti, D. B. (1999) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195133646.001.0001 · Cited by 918
Treatment of Postmenopausal Osteoporosis with Transdermal Estrogen
Lufkin, E. G., Wahner, H. W., O’Fallon, W. M., Hodgson, S. F., Kotowicz, M. A., Lane, A. W., Judd, H. L., Caplan, R. H., & Riggs, B. L. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-117-1-1 · Cited by 813
Estrogen Replacement Therapy and Fractures in Older Women
Cauley, J. A., Seeley, D. G., Ensrud, K. E., Ettinger, B., Black, D., & Cummings, S. R. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-1-199501010-00002 · Cited by 808
Self-citationBone Compressive Strength: The Influence of Density and Strain Rate
Carter, D. R., & Hayes, W. C. (1976) · Science · doi:10.1126/science.996549 · Cited by 709
Statistical validation of intermediate endpoints for chronic diseases
Freedman, L. S., Graubard, B. I., & Schatzkin, A. G. (1992) · Statistics in Medicine · doi:10.1002/sim.4780110204 · Cited by 651
Overgaard, K., Hansen, M. A., Jensen, S. B., & Christiansen, C. (1992) · BMJ · doi:10.1136/bmj.305.6853.556 · Cited by 426
Antifracture Efficacy of Antiresorptive Agents Are Related to Changes in Bone Density
Wasnich, R. D., & Miller, P. D. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.1.6267 · Cited by 414
The Biological Standardization of Insulin
Fieller, E. C. (1941) · Journal of the Royal Statistical Society Series B (Statistical Methodology) · doi:10.2307/2983630 · Cited by 356
Trabecular bone architecture in the pathogenesis and prevention of fracture
PARFITT, A. M. (1987) · The American Journal of Medicine · doi:10.1016/0002-9343(87)90274-9 · Cited by 350
Harris, S. T., Watts, N. B., Jackson, R. D., Genant, H. K., Wasnich, R. D., Ross, P. D., Miller, P. D., Licata, A. A., & Chesnut, C. H. (1993) · The American Journal of Medicine · doi:10.1016/0002-9343(93)90350-x · Cited by 349
Self-citationA 20-Year Perspective on the Mechanical Properties of Trabecular Bone
Keaveny, T. M., & Hayes, W. C. (1993) · Journal of Biomechanical Engineering · doi:10.1115/1.2895536 · Cited by 318
Bone Matters: Are Density Increases Necessary to Reduce Fracture Risk?
Faulkner, K. G. (2000) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.2000.15.2.183 · Cited by 204
Riggs, B. L., Melton, L. J., & O’Fallon, W. M. (1996) · Bone · doi:10.1016/8756-3282(95)00502-1 · Cited by 187
Defining Incident Vertebral Deformity: A Prospective Comparison of Several Approaches
Black, D. M., Palermo, L., Nevitt, M. C., Genant, H. K., Christensen, L., & Cummings, S. R. (1999) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.1999.14.1.90 · Cited by 186
Self-citationVertebral structure and strengthIn vivo andIn vitro
Mosekilde, L. (1993) · Calcified Tissue International · doi:10.1007/bf01673420 · Cited by 159
Architecture and vertebral fracture
Recker, R. R. (1993) · Calcified Tissue International · doi:10.1007/bf01673423 · Cited by 144
Effect of menopause on femoral and vertebral bone loss
Pouillès, J. M., Trémollières, F., & Ribot, C. A. (1995) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650101014 · Cited by 92
Arnaud, C. D., Roe, E. B., Sanchez, S., del Puerto, G. A., Pierni, E., Bachetti, P., & Cann, C. F. (2000) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(00)82061-5 · Cited by 68
Cheng, X. G., Lowet, G., Boonen, S., Nicholson, P., der Perre, G. V., & Dequeker, J. (1998) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.1998.13.9.1439 · Cited by 60
Comparison of rates of bone loss from the spine measured using two manufacturers' densitometers
Peel, N. F. A., & Eastell, R. (1995) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.5650101124 · Cited by 42
Changing perceptions in osteoporosis Commentary: Bone density can be used to assess fracture risk
Wilkin, T. J., & Eastell, R. (1999) · BMJ · doi:10.1136/bmj.318.7187.862 · Cited by 42
Statistical Validation of Surrogate Endpoints: Problems and Proposals
Buyse, M. E., Molenberghs, G., Burzykowski, T., Renard, D., & Geys, H. (2000) · Drug Information Journal · doi:10.1177/009286150003400213 · Cited by 27
Four-year study of intermittent cyclic etidronate treatment of postmenopausal osteoporosis
Loeliger, E. A. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80150-8 · Cited by 14
Research works printed but not linked: 4
- Cummings, 1996, Changes in BMD substantially underestimate the anti-fracture effects of alendronate and other antiresorptive drugs, J Bone Miner Res, 11, S102
- Genant, 1998, Chronic intermittent cyclical administration of tiludronate in postmenopausal osteoporosis, Bone, 23, S175
- Black, 1993, Prediction of new vertebral deformities, J Bone Miner Res, 8, S135
- Cann, 1999, PTH effects in the femur, J Bone Miner Res, 14, S137
Cited by
Sorted by citations
European guidance for the diagnosis and management of osteoporosis in postmenopausal women
Kanis, J. A., McCloskey, E. V., Johansson, H., Cooper, C. C., Rizzoli, R., & Reginster, J. (2012) · Osteoporosis International · doi:10.1007/s00198-012-2074-y · Cited by 2,993
European guidance for the diagnosis and management of osteoporosis in postmenopausal women
on behalf of the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF), Kanis, J. A., Cooper, C., Rizzoli, R., & Reginster, J.-Y. (2019) · Osteoporosis International · doi:10.1007/s00198-018-4704-5 · Cited by 1,900
Epidemiology, etiology, and diagnosis of osteoporosis
Lane, N. E. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.08.047 · Cited by 1,300
for the IOF-IFCC Bone Marker Standards Working Group, Vasikaran, S., Eastell, R., Bruyère, O., Foldes, A. J., Garnero, P., Griesmacher, A., McClung, M., Morris, H. A., Silverman, S., et al. (2011) · Osteoporosis International · doi:10.1007/s00198-010-1501-1 · Cited by 1,212
Manolagas, S. C. (2010) · Endocrine Reviews · doi:10.1210/er.2009-0024 · Cited by 1,234
Metadata
- Authors
- Cummings, S. R., Karpf, D. B., Harris, F., Genant, H. K., Ensrud, K., LaCroix, A. Z., & Black, D. M.
- Affiliations
- University of California, San Francisco (US)
- Geron (United States) (US)
- University of Minnesota (US)
- University of Washington (US)
- Corresponding author
- Cummings, Steven R.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 2002-03
- Volume
- 112
- Issue
- 4
- Pages
- 281-289
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2110828193
- Cited by
- 752
- References
- 35
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 17 · 2023: 12 · 2022: 12 · 2021: 16 · 2020: 25 · 2019: 10 · 2018: 11 · 2017: 18 · 2016: 25 · 2015: 19 · 2014: 24 · 2013: 29 · 2012: 43
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- osteoporosis, vertebral fractures, bone mineral density, antiresorptive agents, alendronate, postmenopausal women, Fracture Intervention Trial, fracture risk reduction, bone mass
- MeSH terms
- Bone Resorption, Female, Fractures, Spontaneous, Humans, Regression Analysis, Risk Factors, Spine, Bone Density, Osteoporosis, Postmenopausal, Logistic Models, Spinal Fractures, Alendronate
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
