Evidence map›Paper›PMID 29222056›Full record

SynthesisOsteoarthritis and cartilage2018

Are bisphosphonates efficacious in knee osteoarthritis? A meta-analysis of randomized controlled trials.

E E Vaysbrot, M C Osani, M-C Musetti, T E McAlindon, R R Bannuru

Registry-linked trialAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Osteoarthritis and cartilage, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05204836 (Altering Bone Microarchitecture and Mechanics by Off-label Pharmaceutical Intervention), which is not on this map. Cited by 55 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
55citing papers in PubMed, 1 pooled it
6.4field-weighted citation impact, top 3% of its field
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.

NCT05204836 phase1terminatednot on this mapstarted 2023, after this paper: background citation

Altering Bone Microarchitecture and Mechanics by Off-label Pharmaceutical Intervention

TypeinterventionalSponsorUniversity of CalgaryRan2023 to 2025Enrolled4ConditionsAnterior Cruciate Ligament Tear, Anterior Cruciate Ligament Rupture, Anterior Cruciate Ligament Injuries, Osteo Arthritis KneeArmsZoledronic Acid Injection, Placebo
3 · Its place in the literature

Who cites it

55 citing papers in PubMed, 1 synthesis or guideline pooled it, 108 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

E E VaysbrotCenter for Treatment Comparison and Integrative Analysis (CTCIA), Division of Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
M C OsaniCenter for Treatment Comparison and Integrative Analysis (CTCIA), Division of Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
M-C MusettiCenter for Treatment Comparison and Integrative Analysis (CTCIA), Division of Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
T E McAlindonCenter for Treatment Comparison and Integrative Analysis (CTCIA), Division of Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA.
R R BannuruCenter for Treatment Comparison and Integrative Analysis (CTCIA), Division of Rheumatology, Tufts Medical Center, 800 Washington Street, 02111 Boston, MA, USA. Electronic address: rbannuru@tuftsmedicalcenter.org.
Tufts Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo clarify the effects of bisphosphonates in knee osteoarthritis (OA) using an up-to-date meta-analysis of randomized controlled trials (RCTs).

designThe protocol is registered in PROSPERO (CRD42017073449). We searched MEDLINE, EMBASE, Google Scholar, Web of Science, and Cochrane Database from inception until August 2017. We included only RCTs comparing any bisphosphonates vs placebo in knee OA patients and reporting validated pain and function scales, radiographic progression, and adverse events (AEs) outcomes. We excluded studies using active comparators or concomitant medications besides non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. We calculated standardized mean differences (SMDs) to account for variation in outcome scales. Random effects meta-analyses were performed.

resultsWe included seven RCTs (3013 patients, 69% female); most patients (N = 2767) received oral risedronate. No pain or function outcomes, regardless of dose, route, time point or measuring instrument, revealed statistically significant results (end of trial pain SMD = -0.16 [95% confidence interval (CI): -0.34, 0.02]). Similarly, we found no statistically significant effect on radiographic progression (risk ratio = 0.98 [95% CI: 0.77, 1.26]). One small RCT in patients with bone marrow lesions (BMLs) suggested a reduction in BML size at 6 months. Bisphosphonates displayed good tolerability, with no statistically significant differences in AE outcomes vs placebo.

conclusionsContrary to prior reviews, our analysis showed that bisphosphonates neither provide symptomatic relief nor defer radiographic progression in knee OA. However, these agents may still be beneficial in certain subsets of patients who display high rates of subchondral bone turnover. Future studies should be directed at defining such OA subsets and investigating the effects of bisphosphonates in those patients.

Indexed as

Bone Density Conservation AgentsDiphosphonatesDisease ProgressionHumansOsteoarthritis, KneePainPain ManagementRadiographyRandomized Controlled Trials as TopicBone Density Conservation AgentsDiphosphonatesBisphosphonatesKneeMeta-analysisOsteoarthritisPainTreatment

Identifiers

PMID29222056
OpenAlexW2772240823

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.