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

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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.·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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RETRACTED: Risedronate Sodium Therapy for Prevention of Hip Fracture in Men 65 Years or Older After Stroke
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Background

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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