Evidence map›Paper›PMID 34524561›Full record

SynthesisArchives of osteoporosis2021

Discontinuation of bisphosphonates in seniors: a systematic review on health outcomes.

Marianne Lamarre, Martine Marcotte, Danielle Laurin, Daniela Furrer, Isabelle Vedel, André Tourigny, Anik Giguère, Pierre-Hugues Carmichael, Rosa Martines, José Morais and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Archives of osteoporosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.1field-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.

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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
  4. Deprescribing in Palliative Cancer Care.Life (Basel, Switzerland) · 2022
    Review
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

11 authors at 5 institutions in 1 country.

Marianne LamarreFaculté de médecine, Université Laval, Quebec City, Quebec, Canada.
Martine MarcotteCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada.
Danielle LaurinCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada.
Daniela FurrerCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada.
Isabelle VedelFaculty of Medicine, McGill University, Montreal, Quebec, Canada.
André TourignyFaculté de médecine, Université Laval, Quebec City, Quebec, Canada.
Anik GiguèreFaculté de médecine, Université Laval, Quebec City, Quebec, Canada.
Pierre-Hugues CarmichaelCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada.
Rosa MartinesCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada.
José MoraisFaculty of Medicine, McGill University, Montreal, Quebec, Canada.
Edeltraut KrögerCentre d'excellence sur le vieillissement de Québec, CIUSSS Capitale Nationale, Quebec City, Quebec, Canada. edeltraut.kroger.ciussscn@ssss.gouv.qc.ca.
Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal · CACentre de Santé et de Services Sociaux de la Vieille-Capitale · CACentre hospitalier de l'Université Laval · CAMcGill University · CAUniversité Laval · CA

Funding

CIHR
6 · The paper itself

Abstract

purposeBisphosphonates are used to treat osteoporosis. Despite their benefits on bone mineral density (BMD) and fractures, they have shown adverse effects, sometimes severe, during chronic use. Taken for several years, they achieve long-term bone retention, making deprescribing feasible. This review aimed to synthesize evidence on the success and health outcomes of deprescribing of bisphosphonates in seniors, aged over 60 years.

methodsThe review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, including articles in English, French, or German published before July 2020. Eligible studies included seniors having discontinued bisphosphonates and reported on health outcomes; some allowed meta-analyses on fracture risk.

resultsThe review included 9 RCTs and 9 cohort studies of moderate quality. Bisphosphonates were discontinued after 2 to 7 years of use, and BMD or fractures were assessed during follow-up of 0.5 to 5 years. A significant reduction in BMD after discontinuation was observed in 9 of 10 studies. Results on fracture risk after discontinuation are mitigated: 6 RCT extensions showed no increase in the risk of any osteoporotic fractures after discontinuation. Meta-analyses including 4 RCTs showed an increased odds ratio of vertebral fractures of 2.04 (95% CI, 1.39-2.99) among discontinuers. Results from 2 large cohort studies showed no increased risks of any osteoporotic or vertebral fractures, while 2 studies found increased fracture risks.

conclusionBisphosphonates have successfully been discontinued low overall fracture risk after at least 3 years of use, but a risk for decreased BMD and increased vertebral fractures remained.

Indexed as

Bone Density Conservation AgentsOsteoporosisOsteoporotic FracturesAgedBone DensityDiphosphonatesHumansOutcome Assessment, Health CareBone Density Conservation AgentsDiphosphonatesBisphosphonatesDeprescribingOlder adultsOsteoporosisSystematic review

Identifiers

PMID34524561
OpenAlexW3199391899

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.