Evidence map›Paper›PMID 32734512›Full record

ReviewCurrent osteoporosis reports2020

Benefits of Bisphosphonate Therapy: Beyond the Skeleton.

Emma O Billington, Ian R Reid

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Current osteoporosis reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06859580 (Bisphosphonate vs. Placebo Prior to Parathyroidectomy in Primary Hyperparathyroidisme), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 13% 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.

NCT06859580 phase4recruitingnot on this mapstarted 2025, after this paper: background citation

Bisphosphonate vs. Placebo Prior to Parathyroidectomy in Primary Hyperparathyroidisme: A Randomized, Double-blinded Placebo-controlled Trial

TypeinterventionalSponsorUniversity of AarhusRan2025 to 2028Enrolled140ConditionsPrimary HyperparathyroidismArmsZoledronic acid 4 mg, Natriumklorid 9 mg/ml, Fresenius Kabi
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. From Bone Health to Lifespan: Pleiotropic Effects of Antiresorptive Agents.Endocrinology and metabolism (Seoul, Korea) · 2025
    Review
  7. Article
  8. Review
  9. Vitamin D deficiency in hip fracture patients is associated with an increased mortality risk.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
    Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Age Related Osteoporosis: Targeting Cellular Senescence.International journal of molecular sciences · 2022
    Review
  20. Simulated effects of early menopausal bone mineral density preservation on long-term fracture risk: a feasibility study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Emma O BillingtonDivision of Endocrinology & Metabolism, Cumming School of Medicine, University of Calgary, Calgary, Canada. emma.billington@albertahealthservices.ca.ORCID 0000-0002-2556-588X
Ian R ReidDepartment of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Alberta Health Services · CAUniversity of Auckland · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewRecent evidence from clinical trials and observational studies raises the possibility that bisphosphonate use might confer a lower risk of cardiovascular disease and cancer, resulting in a mortality benefit. This review summarizes clinical and preclinical studies examining the non-skeletal effects of bisphosphonates. RECENT

findingsData from clinical trials are conflicting regarding whether or not bisphosphonates have beneficial effects on mortality, cardiovascular events, or cancer incidence. No clinical trials have assessed these outcomes as primary endpoints, and most trials were shorter than 4 years. Observational data suggest that bisphosphonate users may have lower mortality, delayed progression of vascular calcification and atherosclerotic burden, and reduced incidence of breast and colorectal cancer compared to non-users. Preclinical studies confirm that bisphosphonates can be taken up by macrophages and monocytes, and nitrogen-containing bisphosphonates have the ability to disrupt the mevalonate pathway within these cells. In this manner, bisphosphonates exert anti-atherogenic and anti-cancer effects. Bisphosphonates also appear to exert protective effects on vascular smooth muscle cells and endothelial cells and may have direct cytotoxic effects on cancer cells. The balance of evidence does not support bisphosphonate treatment for the primary purpose of improving non-skeletal outcomes, although appropriately designed controlled trials that further explore this possibility are both justified and required. Patients with skeletal indications for bisphosphonate therapy can be reassured that these agents are not associated with increased mortality, cardiovascular disease, or cancer incidence.

Indexed as

MortalityAtherosclerosisBone Density Conservation AgentsBreast NeoplasmsColorectal NeoplasmsDiphosphonatesDisease ProgressionEndothelial CellsHumansMacrophagesMevalonic AcidMonocytesMuscle, Smooth, VascularMyocytes, Smooth MuscleProtective FactorsVascular CalcificationBone Density Conservation AgentsDiphosphonatesMevalonic AcidBisphosphonatesCancerCardiovascular diseaseMortalityOsteoporosisZoledronic acid

Identifiers

PMID32734512
OpenAlexW3046892723

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.