Evidence map›Paper›PMID 40425867›Full record

Trial reportJournal of bone and mineral metabolism2025

Evaluation of the fracture prevention effects of teriparatide and alendronate in patients with frailty: a sub-analysis of the Japanese osteoporosis intervention trial-05.

Tatsuya Hosoi, Makoto Yunoki, Shiro Tanaka, Hiroshi Hagino, Satoshi Mori, Satoshi Soen, Sumito Ogawa

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of bone and mineral metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Tatsuya HosoiDepartment of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Makoto YunokiDepartment of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Shiro TanakaDepartment of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hiroshi HaginoDepartment of Rehabilitation, Sanin Rosai Hospital, Yonago, Tottori, Japan.
Satoshi MoriSeirei Hamamatsu General Hospital, Hamamatsu, Japan.
Satoshi SoenSoen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Hyogo, Japan.
Sumito OgawaDepartment of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan. suogawa@m.u-tokyo.ac.jp.ORCID http://orcid.org/0000-0002-5935-276X

Funding

Asahi Kasei Pharma CorporationPublic Health Research Foundation
6 · The paper itself

Abstract

introductionThe fracture prevention effects of teriparatide (TPTD) and alendronate (ALN) were evaluated in frail patients using data from the JOINT-05 trial. In addition, predictors of adherence-related treatment discontinuation were evaluated for TPTD and ALN. MATERIALS AND

methodsJapanese women aged ≥ 75 years with primary osteoporosis and high fracture risk were randomized to either sequential therapy (TPTD for 72 weeks followed by ALN for 48 weeks) or ALN monotherapy for 120 weeks. Cognitive frailty was defined as an MMSE score ≤ 27, and physical frailty as requiring support or nursing care. Vertebral, non-vertebral, and all fractures were assessed. Adherence-related discontinuations were identified, and baseline predictors were analyzed using multiple regression to calculate odds ratios.

resultsA total of 514 patients with cognitive frailty (254 with TPTD, 260 with ALN) and 204 patients with physical frailty (109 with TPTD, 95 with ALN) were identified. In patients with cognitive frailty, vertebral fracture incidence tended to be lower with TPTD (rate ratio 0.72), but not significantly. In patients with physical frailty, the incidence was significantly lower with TPTD (rate ratio 0.50, p < 0.01). Dyslipidemia and serum calcium levels were significant predictors of TPTD discontinuation, whereas cognitive impairment and dyslipidemia were predictors for ALN discontinuation.

conclusionIn patients with physical frailty, TPTD reduced vertebral fractures significantly more than ALN. However, in cases with cognitive impairment, the results of the JOINT-05 study may not necessarily apply. Assessing the presence of dyslipidemia and cognitive decline may be useful for predicting adherence-related discontinuation.

trial registrationjRCTs031180235 and UMIN000015573, March 12, 2019.

Indexed as

AlendronateBone Density Conservation AgentsFrailtyOsteoporosisTeriparatideAgedAged, 80 and overEast Asian PeopleFemaleFrail ElderlyHumansJapanAlendronateBone Density Conservation AgentsTeriparatideAlendronateFractureFrailtyOsteoporosisTeriparatide

Identifiers

PMID40425867
PMCPMC12279556

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Registered trials

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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.