Evidence map›Paper›PMID 27433859›Full record

ArticleMenopause (New York, N.Y.)2016

Long-term oral bisphosphonate use in relation to fracture risk in postmenopausal women with breast cancer: findings from the Women's Health Initiative.

Rebecca L Drieling, Andrea Z LaCroix, Shirley A A Beresford, Denise M Boudreau, Charles Kooperberg, Rowan T Chlebowski, Margery Gass, Carolyn J Crandall, Catherine R Womack, Susan R Heckbert

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Menopause (New York, N.Y.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Effectiveness and safety of bone protective interventions to mitigate bone loss and skeletal fractures experienced by patients with non-metastatic breast cancer: a systematic review and 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 · 2026
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Rebecca L Drieling1University of Washington School of Public Health, Seattle, WA 2Division of Epidemiology and Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA 3Fred Hutchinson Cancer Research Center, Seattle, WA 4Group Health Research Institute, Group Health Cooperative, Seattle, WA 5University of Washington School of Pharmacy, Seattle, WA 6Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles Medical Center, Torrance, CA 7The North American Menopause Society, Cleveland, OH 8David Geffen School of Medicine at University of California, Los Angeles, CA 9University of Tennessee Health Science Center, Memphis, TN.
Andrea Z LaCroix
Shirley A A Beresford
Denise M Boudreau
Charles Kooperberg
Rowan T Chlebowski
Margery Gass
Carolyn J Crandall
Catherine R Womack
Susan R Heckbert

Funding

Biobehavioral Cancer Prevention and Control Training ProgramR25CA092408 · NCI · UNIVERSITY OF WASHINGTON · PI PATRICK, DONALD LEE · 2001 to 2015
$7.1M
NCI NIH HHS R25 CA092408NHLBI NIH HHS HHSN268201100001INHLBI NIH HHS HHSN268201100002INHLBI NIH HHS HHSN268201100003INHLBI NIH HHS HHSN268201100004INHLBI NIH HHS HHSN268201100046CNIA NIH HHS HHSN271201100004CWHI NIH HHS HHSN268201100001CWHI NIH HHS HHSN268201100002CWHI NIH HHS HHSN268201100003CWHI NIH HHS HHSN268201100004C
6 · The paper itself

Abstract

objectiveThe aim of the study was to examine the association of long-term oral bisphosphonate use, compared with short-term use, with fracture risk among postmenopausal women with breast cancer.

methodsWe studied 887 postmenopausal women who were enrolled to the Women's Health Initiative from 1993 to 1998, diagnosed with breast cancer after enrollment, and reported current oral bisphosphonate use of 2 years or more on a medication inventory administered in 2008 to 2009. The outcome of any clinical fracture was ascertained by self-report on an annual study form; a subset of fractures was confirmed with medical records. Women were followed from completion of the medication inventory until 2014. The association between duration of bisphosphonate use reported on the medication inventory and fracture was estimated using multivariate Cox proportional hazards survival models that compared 4 to 7 years and 8 or more years of bisphosphonate use with 2 to 3 years of use.

resultsOn average, women were 76 years of age and were followed for 3.7 (SD 1.1) years. There were 142 clinical fractures. In the multivariate-adjusted analysis for fracture risk factors, 8 or more years of bisphosphonate use was associated with higher risk of fracture compared with 2 to 3 years of use (hazard ratio, 1.67 [95% CI, 1.06-2.62]). There was no significant association of 4 to 7 years of use with fracture.

conclusionsBisphosphonate use of 8 or more years was associated with higher risk of any clinical fracture compared with 2 to 3 years of use. Our findings raise concern about potential harm or decreased effectiveness of long-term bisphosphonate use on fracture risk. The findings warrant confirmatory studies.

Indexed as

Bone Density Conservation AgentsPostmenopauseWomen's HealthAgedBreast NeoplasmsDiphosphonatesFemaleFractures, BoneHumansLongitudinal StudiesProportional Hazards ModelsRisk FactorsTime FactorsBone Density Conservation AgentsDiphosphonates

Identifiers

PMID27433859
PMCPMC5079762

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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.