ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2024
Pre-treatment bone mineral density and the benefit of pharmacologic treatment on fracture risk and BMD change: analysis from the FNIH-ASBMR SABRE project.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 16 citations in OpenAlex.
- Clinical characteristics of the reduced bone mineral density subgroup among adults with type 2 diabetes mellitus: a retrospective cross-sectional study.BMC musculoskeletal disorders · 2026Article
- Management of postmenopausal osteoporosis.Endocrine reviews · 2026Review
- Article
- Multimorbidity patterns among fragility fracture patients aged 50 + years in China and the US.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Longitudinal osteoporosis therapy: treat-to-target and sequential strategies-a narrative review.Therapeutic advances in musculoskeletal disease · 2026Review
- Individualized Fracture Prevention for Postmenopausal Women with Osteopenia.Journal of menopausal medicine · 2025Review
- One-year bone mineral density gains with anti-osteoporotic medications and clinical factors associated with non-BMD gainers.Journal of bone and mineral metabolism · 2025Article
- Effects of secukinumab on skeletal microarchitecture and vertebral fractures in patients with axial spondyloarthritis using HR-pQCT.Archives of osteoporosis · 2025Article
- Fracture risk in Korean postmenopausal women: The influence of BMI, age, and bone density.Osteoporosis and sarcopenia · 2025Article
- Factors influencing therapeutic efficacy of denosumab against osteoporosis in systemic lupus erythematosus.Lupus science & medicine · 2025Article
- The relationship between treatment-related changes in total hip BMD measured after 12, 18, and 24 mo and fracture risk reduction in osteoporosis clinical trials: the FNIH-ASBMR-SABRE project.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Goal-directed osteoporosis treatment: ASBMR/BHOF task force position statement 2024.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Article
- Bone Tissue Changes in Individuals Living with HIV/AIDS: The Importance of a Hierarchical Approach in Investigating Bone Fragility.Journal of personalized medicine · 2024Review
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
Some osteoporosis drug trials have suggested that treatment is more effective in those with low BMD measured by DXA. This study used data from a large set of randomized controlled trials (RCTs) to determine whether the anti-fracture efficacy of treatments differs according to baseline BMD. We used individual patient data from 25 RCTs (103 086 subjects) of osteoporosis medications collected as part of the FNIH-ASBMR SABRE project. Participants were stratified into FN BMD T-score subgroups (≤-2.5, > -2.5). We used Cox proportional hazard regression to estimate treatment effect for clinical fracture outcomes and logistic regression for the radiographic vertebral fracture outcome. We also performed analyses based on BMD quintiles. Overall, 42% had a FN BMD T-score ≤ -2.5. Treatment with anti-osteoporosis drugs led to significant reductions in fractures in both T-score ≤ -2.5 and > -2.5 subgroups. Compared to those with FN BMD T-score > -2.5, the risk reduction for each fracture outcome was greater in those with T-score ≤ -2.5, but only the all-fracture outcome reached statistical significance (interaction P = .001). Results were similar when limited to bisphosphonate trials. In the quintile analysis, there was significant anti-fracture efficacy across all quintiles for vertebral fractures and with greater effects on fracture risk reduction for non-vertebral, all, and all clinical fractures in the lower BMD quintiles (all interaction P ≤ .03). In summary, anti-osteoporotic medications reduced the risk of fractures regardless of baseline BMD. Significant fracture risk reduction with treatment for 4 of the 5 fracture endpoints was seen in participants with T-scores above -2.5, though effects tended to be larger and more significant in those with baseline T-scores <-2.5.
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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.