Comparative Effectiveness of Drug Treatments to Prevent Fragility Fractures: A Systematic Review and Network Meta-Analysis

Murad, Mohammad Hassan; Drake, Matthew T.; Mullan, Rebecca J.; Mauck, Karen F.; Stuart, Louise M.; Lane, Melanie A.; Abu Elnour, Nisrin O.; Erwin, Patricia J.; Hazem, Ahmad; Puhan, Milo A.; Li, Tianjing; Montori, Victor M.

doi:10.1210/jc.2011-3060

Cited by 277Bone health and osteoporosis researchBone health and treatmentsMenopause: Health Impacts and Treatments

Comparative Effectiveness of Drug Treatments to Prevent Fragility Fractures: A Systematic Review and Network Meta-Analysis

Murad, Mohammad Hassan, Drake, Matthew T., Mullan, Rebecca J., Mauck, Karen F., Stuart, Louise M., Lane, Melanie A., Abu Elnour, Nisrin O., Erwin, Patricia J. +4 more·2012·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2011-3060

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Abstract

CONTEXT: Osteoporosis and osteopenia are associated with increased fracture incidence. OBJECTIVE: The aim of this study was to determine the comparative effectiveness of different pharmacological agents in reducing the risk of fragility fractures. DATA SOURCES: We searched multiple databases through 12/9/2011. STUDY SELECTION: Eligible studies were randomized controlled trials enrolling individuals at risk of developing fragility fractures and evaluating the efficacy of bisphosphonates, teriparatide, selective estrogen receptor modulators, denosumab, or calcium and vitamin D. DATA EXTRACTION: Reviewers working independently and in duplicate determined study eligibility and collected descriptive, methodological quality, and outcome data. DATA SYNTHESIS: This network meta-analysis included 116 trials (139,647 patients; median age, 64 yr; 86% females and 88% Caucasians; median follow-up, 24 months). Trials were at low to moderate risk of bias. Teriparatide had the highest risk reduction of fractures (odds ratios, 0.42, 0.30, and 0.50 for hip, vertebral, and nonvertebral fractures, respectively) and the highest probability of being ranked first for efficacy (probabilities of 42, 49, and 79% for hip, vertebral, and nonvertebral fractures, respectively). However, differences to denosumab, zoledronate, risedronate, ibandronate, and alendronate were not statistically significant. Raloxifene and bazedoxifene were likely less effective, although these data were limited. Calcium and vitamin D were ineffective given separately but reduced the risk of hip fractures if given in combination (odds ratio, 0.81; 95% confidence interval, 0.68–0.96). CONCLUSIONS: Teriparatide, bisphosphonates, and denosumab are most effective in reducing the risk of fragility fractures. Differences in efficacy across drugs are small; therefore, patients and clinicians need to consider their associated harms and costs.

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For four meta-analyses, it was unclear if omission of the affected trial reports would alter the findings.
“For four meta-analyses, it was unclear if omission of the affected trial reports would alter the findings (Richy et al 25 79 citations, October 2018; Richy et al 26 91 citations, February 2018; Murad et al 27 26 citations, August 2018; Yang et al 28 54 citations, October 2018).”
From An investigation into the impact and implications of published papers from retracted research: systematic search of affected literature (2019) · cites this paper as [27]

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Side effects of drugs for osteoporosis and metastatic bone disease
Skjødt, M. K., Frost, M., & Abrahamsen, B. (2018) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13759 · Cited by 153 · see citing works
“The antiresorptive treatments comprise selective oestrogen receptor modulators[3], bisphosphonates[4, 5], and denosumab[6], and used to include strontium[7], which has been discontinued due to side effects, and oestrogen replacement[8], generally considered unfavourable due to concerns regarding the balance in risks a…”
Background
Calcium supplements: benefits and risks
Reid, I. R., Bristow, S. M., & Bolland, M. J. (2015) · Journal of Internal Medicine · doi:10.1111/joim.12394 · Cited by 152 · see citing works
Pharmacological Management of Postmenopausal Osteoporosis: a Level I Evidence Based - Expert Opinion
Migliorini, F., Colarossi, G., Baroncini, A., Eschweiler, J., Tingart, M., & Maffulli, N. (2020) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2021.1851192 · Cited by 149 · see citing works
Safety of osteoanabolic therapy: A decade of experience
Capriani, C., Irani, D., & Bilezikian, J. P. (2012) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1800 · Cited by 141 · see citing works
Teriparatide improves volumetric bone mineral density and fine bone structure in the UIV+1 vertebra, and reduces bone failure type PJK after surgery for adult spinal deformity
Yagi, M., Ohne, H., Konomi, T., Fujiyoshi, K., Kaneko, S., Komiyama, T., Takemitsu, M., Yato, Y., Machida, M., & Asazuma, T. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3676-6 · Cited by 139 · see citing works
“Most studies on TP’s effects have assessed twodimensional BMD by dual-energy X-ray absorptiometry (DXA) scans [28, 29].”
BackgroundMethodInfluential
Drug holidays from bisphosphonates and denosumab in postmenopausal osteoporosis: EMAS position statement
Anagnostis, P. G., Paschou, S. Α., Mintziori, G., Ceauşu, I., Depypere, H. T., Lambrinoudaki, I. V., Mueck, A. O., Pérez-López, F. R., Rees, M., Senturk, L. M., et al. (2017) · Maturitas · doi:10.1016/j.maturitas.2017.04.008 · Cited by 129 · see citing works
Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group
Chevalley, T., Brandi, M. L., Cashman, K. D., Cavalier, E., Harvey, N. C., Maggi, S., Cooper, C. C., Al‐Daghri, N. M., Bock, O., Bruyère, O., et al. (2022) · Aging Clinical and Experimental Research · doi:10.1007/s40520-022-02279-6 · Cited by 136 · see citing works
THERAPY OF ENDOCRINE DISEASE: Denosumab vs bisphosphonates for the treatment of postmenopausal osteoporosis
Anastasilakis, A. D., Pοlyzos, S. A., & Makras, P. (2018) · European Journal of Endocrinology · doi:10.1530/eje-18-0056 · Cited by 123 · see citing works
Teriparatide versus bisphosphonates for treatment of postmenopausal osteoporosis: A meta-analysis
Yuan, F., Peng, W. H., Cai-hong, Y., & Zheng, J. (2019) · International Journal of Surgery · doi:10.1016/j.ijsu.2019.03.004 · Cited by 122 · see citing works
Nutritional aspects of bone health
Rizzoli, R. (2014) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2014.08.003 · Cited by 115 · see citing works
Effects of teriparatide on hip and upper limb fractures in patients with osteoporosis: A systematic review and meta-analysis
Díez‐Pérez, A., Marín, F., Eriksen, E. F., Kendler, D. L., Krege, J. H., & Delgado‐Rodríguez, M. (2018) · Bone · doi:10.1016/j.bone.2018.09.020 · Cited by 110 · see citing works
Meta-analysis of genome-wide studies identifies WNT16 and ESR1 SNPs associated with bone mineral density in premenopausal women
Koller, D. L., Zheng, H., Karasik, D., Yerges‐Armstrong, L. M., Liu, C., McGuigan, F. E., Kemp, J. P., Giroux, S., Lai, D., Edenberg, H. J., et al. (2012) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1796 · Cited by 104 · see citing works
Efficacy, effectiveness and side effects of medications used to prevent fractures
Reid, I. R. (2014) · Journal of Internal Medicine · doi:10.1111/joim.12339 · Cited by 99 · see citing works
Long-term treatment of osteoporosis: safety and efficacy appraisal of denosumab
Anastasilakis, A. D. (2012) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s24239 · Cited by 92 · see citing works
Effects of teriparatide on cortical histomorphometric variables in postmenopausal women with or without prior alendronate treatment
Ma, Y. L., Zeng, Q. Q., Chiang, A. Y., Burr, D. B., Li, J., Dobnig, H., Fahrleitner‐Pammer, A., Michalská, D., Marín, F., Pavo, I. J., et al. (2013) · Bone · doi:10.1016/j.bone.2013.11.011 · Cited by 90 · see citing works
“While most antiresorptive agents result in a reduction of vertebral fracture risk by about 50%, they are less effective in preventing non-vertebral fracture where the reduction in risk is 20% to 30% [8].”
Background
Effects of a 12-Month Supervised, Community-Based, Multimodal Exercise Program Followed by a 6-Month Research-to-Practice Transition on Bone Mineral Density, Trabecular Microarchitecture, and Physical Function in Older Adults: A Randomized Controlled Trial
Daly, R. M., Gianoudis, J., Kersh, M. E., Bailey, C. A., Ebeling, P. R., Krug, R., Nowson, C. A., Hill, K., & Sanders, K. M. (2019) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3865 · Cited by 88 · see citing works
“are used as a first-line treatment because they can reduce fracture risk by 30% to 60%,((1,2)) but they are limited to osteopo-”
Method
Vitamin D Supplementation and Fractures in Adults: A Systematic Umbrella Review of Meta-Analyses of Controlled Trials
Chakhtoura, M., Bacha, D. S., Gharios, C., Ajjour, S., Assaad, M. A., Jabbour, Y., Kahale, F., Bassatne, A., Antoun, S., Akl, E. A., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab742 · Cited by 85 · see citing works
“a MAs not included in the matrix: Abrahamsen 2010: IPD without details about individual RCTs(23); Murad 2012: Network MA without details about Ca/D vs placebo(28); Tricco 2017: Network MA without details about individual RCTs(39).”
BackgroundInfluential
A Review of Osteoporosis in the Older Adult
Alejandro, P., & Constantinescu, F. (2018) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2018.03.004 · Cited by 80 · see citing works
Progesterone for the prevention and treatment of osteoporosis in women
Prior, J. C. (2018) · Climacteric · doi:10.1080/13697137.2018.1467400 · Cited by 80 · see citing works
Clinical effectiveness of bisphosphonates for the prevention of fragility fractures: A systematic review and network meta-analysis
Sanderson, J., James, M. M., Stevens, J., Goka, E., Wong, R., Campbell, F., Selby, P. L., Gittoes, N. J. L., & Davis, S. (2016) · Bone · doi:10.1016/j.bone.2016.05.013 · Cited by 76 · see citing works
Pharmacological inhibition of cathepsin K: A promising novel approach for postmenopausal osteoporosis therapy
Mukherjee, K., & Chattopadhyay, N. (2016) · Biochemical Pharmacology · doi:10.1016/j.bcp.2016.04.010 · Cited by 75 · see citing works
Male Osteoporosis
Drake, M. T., & Khosla, S. (2012) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2012.05.001 · Cited by 73 · see citing works
“Accordingly, the reader is referred to a recently published meta-analysis of the comparative effectiveness of currently available pharmacologic agents for reducing fracture risk in men.(68)”
Self-citation
Clinical effectiveness of denosumab, raloxifene, romosozumab, and teriparatide for the prevention of osteoporotic fragility fractures: A systematic review and network meta-analysis
Simpson, E. L., James, M. M., Hamilton, J. A., Wong, R., Gittoes, N. J. L., Selby, P. L., & Davis, S. (2019) · Bone · doi:10.1016/j.bone.2019.115081 · Cited by 72 · see citing works
“This finding complements previous NMAs that have shown benefit on vertebral fracture risk for bisphosphonates, RLX, DEN and TPTD,(15) (23) (24) Unlike other NMAs, this article includes the newer drug ROMO within a NMA against the nonbisphosphonates and bisphosphonates currently recommended for UK treatment.”
Result
Zoledronate
Reid, I. R., Green, J. R., Lyles, K. W., Reid, D. M., Trechsel, U., Hosking, D. J., Black, D. M., Cummings, S. R., Russell, R. G. G., & Eriksen, E. F. (2020) · Bone · doi:10.1016/j.bone.2020.115390 · Cited by 68 · see citing works
Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women
Yusuf, A., Cummings, S. R., Watts, N. B., Feudjo, M., Sprafka, J. M., Zhou, J., Guo, H., Balasubramanian, A., & Cooper, C. C. (2018) · Archives of Osteoporosis · doi:10.1007/s11657-018-0439-3 · Cited by 68 · see citing works
Management of Osteoporosis in Men: A Narrative Review
Vescini, F., Chiodini, I., Falchetti, A., Palermo, A., Salcuni, A. S., Bonadonna, S., Geronimo, V. D., Cesareo, R., Giovanelli, L., Brigo, M., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms222413640 · Cited by 68 · see citing works
Dispositional resilience as a moderator of the relationship between chronic stress and irregular menstrual cycle
Palm-Fischbacher, S., & Ehlert, U. (2014) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/0167482x.2014.912209 · Cited by 67 · see citing works
A comparison of parathyroid hormone-related protein (1-36) and parathyroid hormone (1-34) on markers of bone turnover and bone density in postmenopausal women: The PrOP study
Horwitz, M. J., Augustine, M., Kahn, L., Martin, E. A., Oakley, C. C., Carneiro, R. M., Tedesco, M. B., Laslavic, A., Sereika, S. M., Bisello, A., et al. (2013) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1978 · Cited by 65 · see citing works
Recommendations for preventing fracture in long-term care
Παπαϊωάννου, Α., Santesso, N. A., Morin, S. N., Feldman, S., Adachi, J. D., Crilly, R., Giangregorio, L., Jaglal, S. B., Josse, R. G., Kaasalainen, S., et al. (2015) · Canadian Medical Association Journal · doi:10.1503/cmaj.141331 · Cited by 64 · see citing works
The Belgian Bone Club 2020 guidelines for the management of osteoporosis in postmenopausal women
Sánchez‐Rodríguez, D., Bergmann, P., Body, J., Cavalier, E., Gielen, E., Goemaere, S., Lapauw, B., Laurent, M. R., Rozenberg, S., Honvo, G., et al. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.05.006 · Cited by 63 · see citing works
“The second NMA, published in 2012, concluded that calcium and vitamin D reduced the risk of hip fracture if they were administered together but not separately [8].”
Background
An investigation into the impact and implications of published papers from retracted research: systematic search of affected literature
Avenell, A., Stewart, F., Grey, A., Gamble, G., & Bolland, M. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031909 · Cited by 62 · see citing works
Denosumab compared to other treatments to prevent or treat osteoporosis in individuals at risk of fracture: a systematic review and meta-analysis
Beaudoin, C., Jean, S., Bessette, L., Ste‐Marie, L., Moore, L., & Brown, J. P. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3607-6 · Cited by 62 · see citing works
Exercise, nutrition and managing hip fracture in older persons.
Singh, M. F. F. (2013) · Current opinion in clinical nutrition and metabolic care · doi:10.1097/mco.0000000000000015 · Cited by 31 · see citing works
Comparison of the effects of three oral bisphosphonate therapies on the peripheral skeleton in postmenopausal osteoporosis: the TRIO study
Paggiosi, M., Peel, N. F. A., McCloskey, E. V., Walsh, J., & Eastell, R. (2014) · Osteoporosis International · doi:10.1007/s00198-014-2817-z · Cited by 59 · see citing works
Denosumab compared to bisphosphonates to treat postmenopausal osteoporosis: a meta-analysis
Wu, J., Zhang, Q., Yan, G., & Jin, X. (2018) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-018-0865-3 · Cited by 58 · see citing works
“[22] conducted a network meta-analysis and compared with different drugs for preventing fragility fractures.”
Method
A randomized, controlled trial of once-weekly teriparatide injection versus alendronate in patients at high risk of osteoporotic fracture: primary results of the Japanese Osteoporosis Intervention Trial-05
Hagino, H., Sugimoto, T., Tanaka, S., Sasaki, K., Sone, T., Nakamura, T., Soen, S., & Mori, S. (2021) · Osteoporosis International · doi:10.1007/s00198-021-05996-2 · Cited by 56 · see citing works
“Results of a network meta-analysis of randomized, controlled trials have shown that teriparatidemay be the most effective anti-osteoporosis agent in reducing the risk of fractures [3].”
Background
The Effect of Postoperative Use of Teriparatide Reducing Screw Loosening in Osteoporotic Patients
Kim, J. W., Park, S. W., Kim, Y.-B., & Ko, M. J. (2018) · Journal of Korean Neurosurgical Society · doi:10.3340/jkns.2017.0216 · Cited by 55 · see citing works
Osteoporosis in men
Walsh, J., & Eastell, R. (2013) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2013.171 · Cited by 56 · see citing works
Biochemical markers for assessment of calcium economy and bone metabolism: application in clinical trials from pharmaceutical agents to nutritional products
Bonjour, J., Kohrt, W. M., Levasseur, R., Warren, M. P., Whiting, S. J., & KRAENZLIN, M. E. (2014) · Nutrition Research Reviews · doi:10.1017/s0954422414000183 · Cited by 54 · see citing works
Should We Prescribe Calcium Supplements For Osteoporosis Prevention?
Reid, I. R. (2014) · Journal of Bone Metabolism · doi:10.11005/jbm.2014.21.1.21 · Cited by 54 · see citing works
“1) in community-dwelling individuals.[9,10] Therefore, the rationale for continuing to use calcium supplements for osteoporosis management is under question, and this questioning becomes even more acute when the possible side-effects of calcium supplements are considered.”
Background
Combination therapy with parathyroid hormone analogs and antiresorptive agents for osteoporosis: a systematic review and meta-analysis of randomized controlled trials
Lou, S., Lv, H., Yin, P., Li, Z., Tang, P., & Wang, Y. (2018) · Osteoporosis International · doi:10.1007/s00198-018-4790-4 · Cited by 54 · see citing works
Effect of medications on prevention of secondary osteoporotic vertebral compression fracture, non-vertebral fracture, and discontinuation due to adverse events: a meta-analysis of randomized controlled trials
Jin, Y., Lee, J. H., Xu, B., & Cho, M. (2019) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-019-2769-8 · Cited by 52 · see citing works
Abaloparatide for risk reduction of nonvertebral and vertebral fractures in postmenopausal women with osteoporosis: a network meta-analysis
Reginster, J.-Y., Bianic, F., Campbell, R., Martin, M., Williams, S. A., & Fitzpatrick, L. A. (2019) · Osteoporosis International · doi:10.1007/s00198-019-04947-2 · Cited by 51 · see citing works
Structural characterization and osteoprotective effects of a polysaccharide purified from Achyranthes bidentata
Zhang, D., Wang, C., Hou, X., & Yan, C. (2019) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2019.08.013 · Cited by 50 · see citing works
Clinical Evaluation of Cost Efficacy of Drugs for Treatment of Osteoporosis: A Meta-Analysis
Albert, S. G., & Reddy, S. (2017) · Endocrine Practice · doi:10.4158/ep161678.ra · Cited by 49 · see citing works
Osteoporosis in chronic obstructive pulmonary disease
Romme, E. A., Smeenk, F. W. J. M., Rutten, E. P. A., & Wouters, E. F. �. (2013) · Expert Review of Respiratory Medicine · doi:10.1586/17476348.2013.814402 · Cited by 49 · see citing works
Use of antiosteoporotic drugs and calcium/vitamin D in patients with fragility fractures: impact on re-fracture and mortality risk
on the behalf of the Study group, Esposti, L. D., Girardi, A. M., Saragoni, S., Sella, S., Andretta, M., Rossini, M., & Giannini, S. (2018) · Endocrine · doi:10.1007/s12020-018-1824-9 · Cited by 48 · see citing works
Effect of antiresorptive drugs in the alveolar bone healing. A histometric and immunohistochemical study in ovariectomized rats
Ramalho‐Ferreira, G., Faverani, L. P., Momesso, G. A. C., Luvizuto, E. R., Puttini, I. D. O., & Okamoto, R. (2016) · Clinical Oral Investigations · doi:10.1007/s00784-016-1909-x · Cited by 47 · see citing works
Targeted Delivery Systems for Molecular Therapy in Skeletal Disorders
Dang, L., Liu, J., Li, F., Wang, L., Li, D., Guo, B., He, X., Jiang, F., Liang, C., Liu, B., et al. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17030428 · Cited by 45 · see citing works
Predicting the 10-year risk of hip and major osteoporotic fracture in rheumatoid arthritis and in the general population: an independent validation and update of UK FRAX without bone mineral density
Klop, C., de Vries, F., Bijlsma, J. W. J., Leufkens, H. G. M., & Welsing, P. M. J. (2016) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2015-208958 · Cited by 43 · see citing works
New anabolic therapies for osteoporosis
Minisola, S., Cipriani, C., Occhiuto, M., & Pepe, J. (2017) · Internal and Emergency Medicine · doi:10.1007/s11739-017-1719-4 · Cited by 43 · see citing works
“These general measures can be effective [13], especially in elderly subjects confined to nursing homes, and the vitamin D deficient; however, medical therapy is needed when a previous fracture has already occurred.”
Background
Advances in Controlled Drug Delivery for Treatment of Osteoporosis
Asafo-Adjei, T. A., Chen, A. J., Najarzadeh, A., & Puleo, D. A. (2016) · Current Osteoporosis Reports · doi:10.1007/s11914-016-0321-4 · Cited by 43 · see citing works
Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan
Moriwaki, K., & Noto, S. (2016) · Osteoporosis International · doi:10.1007/s00198-016-3777-2 · Cited by 43 · see citing works
“The RR of alendronate for hip, vertebral, and other fractures was derived from a published network meta-analysis estimating the comparative effectiveness of different drug therapies in reducing the risk of fragility fractures [31].”
Method
Network Meta-analysis for Clinical Practice Guidelines: A Case Study on First-Line Medical Therapies for Primary Open-Angle Glaucoma
Rouse, B., Cipriani, A., Shi, Q., Coleman, A. L., Dickersin, K., & Li, T. (2016) · Annals of Internal Medicine · doi:10.7326/m15-2367 · Cited by 41 · see citing works
“The Endocrine Society commissioned a network meta-analysis to inform recommendations of treatment for its 2012 clinical practice guideline for osteoporosis in men (47, 48).”
Self-citation
Alendronate, a bisphosphonate, increased upper and lower gastrointestinal bleeding: risk factor analysis from a nationwide population-based study
Peng, Y.-L., Hu, H., Luo, J., Hou, M., Lin, H., & Lee, F.-Y. (2014) · Osteoporosis International · doi:10.1007/s00198-014-2647-z · Cited by 40 · see citing works
Effect of a dedicated osteoporosis health professional on screening and treatment in outpatients presenting with acute low trauma non-hip fracture: a systematic review
Bell, K., Strand, H., & Inder, W. J. (2014) · Archives of Osteoporosis · doi:10.1007/s11657-013-0167-7 · Cited by 39 · see citing works
“Pharmacological treatment of osteoporosis has been shown to reduce the likelihood of fracture by between 50 and 67 % [40].”
Background
Cost-effectiveness of denosumab versus oral alendronate for elderly osteoporotic women in Japan
Mori, T., Crandall, C. J., & Ganz, D. A. (2017) · Osteoporosis International · doi:10.1007/s00198-017-3940-4 · Cited by 39 · see citing works
Effect of vitamin D replacement on indexes of insulin resistance in overweight elderly individuals: a randomized controlled trial
Fuleihan, G. E., Baddoura, R., Habib, R., Halaby, G., Arabi, A., Rahme, M., Singh, R. J., Kassem, M. S., Mahfoud, Z. R., Hoteit, M., et al. (2016) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.116.132589 · Cited by 38 · see citing works
2013 Up-date of the consensus statement of the Spanish Menopause Society on postmenopausal osteoporosis
Mendoza, N., Sánchez‐Borrego, R., Villero, J., Baró, F., Calaf, J., Hidalgo, M. J. C., Coronado, P., Estévez, A., Fernández-Moya, J. M., Rodríguez, S. P. G., et al. (2013) · Maturitas · doi:10.1016/j.maturitas.2013.05.021 · Cited by 36 · see citing works
Efficacy and safety of denosumab compared to bisphosphonates in improving bone strength in postmenopausal osteoporosis: a systematic review
Chandran, T., & Venkatachalam, I. (2019) · Singapore Medical Journal · doi:10.11622/smedj.2019028 · Cited by 36 · see citing works
“systematic reviews compared denosumab with bisphosphonates; two meta-analyses used vertebral fracture as the endpoint,((9,10)) while two other reviews used differences in BMD changes((11)) and fragility fractures((12)) as endpoints in indirect head-to-head comparisons.”
Women’s Values and Preferences Regarding Osteoporosis Treatments: A Systematic Review
Barrionuevo, P., Gionfriddo, M. R., Castañeda-Guarderas, A., Zeballos-Palacios, C. L., Bora, P. R., Mohammed, K. S., Benkhadra, K., Sarigianni, M., & Murad, M. H. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00193 · Cited by 36 · see citing works
Self-citation
Which is the preferred site for bone mineral density monitoring as an indicator of treatment-related anti-fracture effect in routine clinical practice? A registry-based cohort study
Leslie, W. D., Martineau, P., Bryanton, M., & Lix, L. M. (2019) · Osteoporosis International · doi:10.1007/s00198-019-04975-y · Cited by 36 · see citing works
Improvement needed in the network geometry and inconsistency of Cochrane network meta-analyses: a cross-sectional survey
Gao, Y., Ge, L., Ma, X., Shen, X., Liu, M., & Tian, J. (2019) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2019.05.022 · Cited by 36 · see citing works
New Developments in Fracture Risk Assessment for Current Osteoporosis Reports
Leslie, W. D., & Morin, S. N. (2020) · Current Osteoporosis Reports · doi:10.1007/s11914-020-00590-7 · Cited by 36 · see citing works
Comparative safety and effectiveness of alendronate versus raloxifene in women with osteoporosis
Kim, Y.-S., Tian, Y., Yang, J., Huser, V., Jin, P., Lambert, C. G., Park, H., You, S. C., Park, R. W., Rijnbeek, P. R., et al. (2020) · Scientific Reports · doi:10.1038/s41598-020-68037-8 · Cited by 36 · see citing works
Oral Administration of Quercetin or Its Derivatives Inhibit Bone Loss in Animal Model of Osteoporosis
Huang, Y.-Y., Wang, Z.-H., Deng, L.-H., Wang, H., & Zheng, Q. (2020) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2020/6080597 · Cited by 35 · see citing works
“Physical activity [5], supplementing with calcium and vitamin D, [6, 7] and pharmacological therapies [8] (including estrogen [9], bisphosphonates [10], denosumab [11], or teriparatide [12]) are the most commonly used clinical approaches for the prevention or treatment of osteoporosis.”
Background
Fracture risk in long term care: a systematic review and meta-analysis of prospective observational studies
Khatib, R., Santesso, N. A., Pickard, L. E., Osman, O., Giangregorio, L., Skidmore, C. J., & Παπαϊωάννου, Α. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-130 · Cited by 34 · see citing works
“Treatments to reduce the risk of fractures are available [12].”
Background
Bone Microstructure in Response to Vitamin D3 Supplementation: A Randomized Placebo-Controlled Trial
Bislev, L. S., Rødbro, L. L., Rolighed, L., Sikjær, T., & Rejnmark, L. (2018) · Calcified Tissue International · doi:10.1007/s00223-018-0481-6 · Cited by 33 · see citing works
Orthogeriatric co-management for the care of older subjects with hip fracture: recommendations from an Italian intersociety consensus
Vincentis, A. D., Behr, A. U., Bellelli, G., Bravi, M., Castaldo, A., Galluzzo, L., Iolascon, G., Maggi, S., Martini, E., Momoli, A., et al. (2021) · Aging Clinical and Experimental Research · doi:10.1007/s40520-021-01898-9 · Cited by 34 · see citing works
New and developing pharmacotherapy for osteoporosis in men
Gennari, L., & Bilezikian, J. P. (2018) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2018.1428559 · Cited by 34 · see citing works
Denosumab vs. bisphosphonates in primary osteoporosis: a meta-analysis of comparative safety in randomized controlled trials
Kobayashi, T., Morimoto, T., Ito, K., Mawatari, M., & Shimazaki, T. (2024) · Osteoporosis International · doi:10.1007/s00198-024-07118-0 · Cited by 33 · see citing works
“The relative efficacy of denosumab, alendronate, and ibandronate in preventing fractures remain controversial [6, 21, 26, 29].”
Menopause and Aging
Løbo, R. A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-47912-7.00014-7 · Cited by 32 · see citing works
Cost‐Effectiveness of Sequential Teriparatide/Alendronate Versus Alendronate‐Alone Strategies in High‐Risk Osteoporotic Women in the US: Analyzing the Impact of Generic/Biosimilar Teriparatide
Mori, T., Crandall, C. J., & Ganz, D. A. (2019) · JBMR Plus · doi:10.1002/jbm4.10233 · Cited by 31 · see citing works
Atypical femoral fractures
Giannini, S. (2013) · Clinical cases in mineral and bone metabolism · doi:10.11138/ccmbm/2013.10.1.030 · Cited by 30 · see citing works
“Currently there are several drug classes for the treatment of osteoporosis: estrogen , selective estrogen receptor modulators (SERMs) (such as raloxifene and bazedoxifene), antiresorptive drugs [such as bisphosphonates (BPs)], anabolic drugs [such as recombinant human parathormon (rh-PTH)], dual action drug (such as s…”
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Authors: Murad, M. H., Drake, M. T., Mullan, R. J., Mauck, K. F., Stuart, L. M., Lane, M. A., Abu Elnour, N. O., Erwin, P. J., Hazem, A., Puhan, M. A., Li, T., & Montori, V. M.
Affiliations: Knowledge and Evaluation Research Unit (M.H.M., R.J.M., L.M.S., M.A.L., N.O.A.E., V.M.M.), Rochester, Minnesota 55905
Division of Endocrinology, Diabetes, Metabolism, Nutrition (M.T.D., V.M.M.), Rochester, Minnesota 55905
University of Minnesota Rochester (US)
Mayo Clinic (US)
University of North Dakota (US)
Johns Hopkins University (US)
Corresponding author: Murad, Mohammad Hassan
ORCID: Murad, Mohammad Hassan
Drake, Matthew T.
Mauck, Karen F.
Puhan, Milo A.
Li, Tianjing
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2012-06-01
Volume: 97
Issue: 6
Pages: 1871-1880
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2011-3060
OpenAlex: W2103599857
Cited by: 277
References: 48
Citations by year: 2026: 8 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 12 · 2021: 18 · 2020: 33 · 2019: 36 · 2018: 23 · 2017: 15 · 2016: 27 · 2015: 23 · 2014: 35 · 2013: 23 · 2012: 7
FWCI: 5.04
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Oncology › Bone health and treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: fragility fractures, osteoporosis, osteopenia, fracture prevention, teriparatide, bisphosphonates, denosumab, selective estrogen receptor modulators, raloxifene, bazedoxifene, calcium and vitamin D, hip fracture, vertebral fractures, comparative effectiveness
MeSH terms: Denosumab, Antibodies, Monoclonal, Calcium, Humans, Osteoporosis, Vitamin D, Selective Estrogen Receptor Modulators, Bone Density Conservation Agents, Fractures, Bone, Antibodies, Monoclonal, Humanized

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Comparative Effectiveness of Drug Treatments to Prevent Fragility Fractures: A Systematic Review and Network Meta-Analysis

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