SynthesisBMC musculoskeletal disorders2011
The relative efficacy of nine osteoporosis medications for reducing the rate of fractures in post-menopausal women.
Synthesis in BMC musculoskeletal disorders, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women.The Cochrane database of systematic reviews · 2025Pooled it
- Etidronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women.The Cochrane database of systematic reviews · 2024Pooled it
- Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women.The Cochrane database of systematic reviews · 2022Pooled it
- Recommendations for preventing fracture in long-term care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015Guideline
- Comparative gastrointestinal safety of bisphosphonates in primary osteoporosis: a network meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2014Pooled it
- Efficacy of two calcifediol supplementation regimens in older adults post-hip fracture surgery. A clinical trial.European geriatric medicine · 2026Trial
- Zoledronic acid and bone health in older adults with cognitive impairment.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Trial
- Correlation between diabetes mellitus and refracture risk in patients with osteoporotic fractures: a retrospective cohort study.Aging clinical and experimental research · 2025Article
- Opportunistic hand radiographs to screen for low forearm bone mineral density: a prospective and retrospective cohort study.BMC musculoskeletal disorders · 2024Article
- Anti-osteoporotic Drug Utilization Rates for Secondary Prevention Among Patients with Osteoporotic Fractures.Rambam Maimonides medical journal · 2022Article
- Ubiquitin-specific protease 53 promotes osteogenic differentiation of human bone marrow-derived mesenchymal stem cells.Cell death & disease · 2021Article
- The Effects of Trends in Osteoporosis Treatment on the Incidence of Fractures.Journal of osteoporosis · 2021Article
- Patient-Level Modeling Approach Using Discrete-Event Simulation: A Cost-Effectiveness Study of Current Treatment Guidelines for Women with Postmenopausal Osteoporosis.Journal of managed care & specialty pharmacy · 2019Article
- Five-year refracture rates of a province-wide fracture liaison service.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
- Efficacy and Safety of the Biosimilar Recombinant Human Parathyroid Hormone CinnoparIranian journal of public health · 2018Article
- Comparison of Osteoporosis Pharmacotherapy Fracture Rates: Analysis of a MarketScanInternational journal of endocrinology and metabolism · 2018Article
- Real-world effectiveness of osteoporosis therapies for fracture reduction in post-menopausal women.Archives of osteoporosis · 2018Article
- Real-world evidence of raloxifene versus alendronate in preventing non-vertebral fractures in Japanese women with osteoporosis: retrospective analysis of a hospital claims database.Journal of bone and mineral metabolism · 2018Article
- Economic Analysis of Bisphosphonate Use after Distal Radius Fracture for Prevention of Hip Fracture.The archives of bone and joint surgery · 2017Article
- FRAX for fracture prediction shorter and longer than 10 years: the Manitoba BMD registry.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundIn the absence of head-to-head trials, indirect comparisons of randomized placebo-controlled trials may provide a viable option to assess relative efficacy. The purpose was to estimate the relative efficacy of reduction of fractures in post-menopausal women, and to assess robustness of the results.
methodsA systematic literature review of multiple databases identified randomized placebo-controlled trials with nine drugs for post-menopausal women. Odds ratio and 95% credibility intervals for the rates of hip, non-vertebral, vertebral, and wrist fractures for each drug and between drugs were derived using a Bayesian approach. A drug was ranked as the most efficacious if it had the highest posterior odds ratio, or had the highest effect size.
results30 studies including 59,209 patients reported fracture rates for nine drugs: alendronate (6 studies), denosumab (1 study), etidronate (8 studies), ibandronate (4 studies), raloxifene (1 study), risedronate (7 studies), strontium (2 study), teriparatide (1 study), and zoledronic acid (1 study). The drugs with the highest probability of reducing non-vertebral fractures was etidronate and teriparatide while the drugs with the highest probability of reducing vertebral, hip or wrist fractures were teriparatide, zoledronic acid and denosumab. The drugs with the largest effect size for vertebral fractures were zoledronic acid, teriparatide and denosumab, while the drugs with the highest effect size for non-vertebral, hip or wrist fractures were alendronate or risedronate. Estimates were consistent between Bayesian and classical approaches.
conclusionTeriparatide, zoledronic acid and denosumab have the highest probabilities of being most efficacious for non-vertebral and vertebral fractures, and having the greatest effect sizes. The estimates from indirect comparisons were robust to differences in methodology.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.