Evidence map›Paper›PMID 41591403›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Bisphosphonate treatment for secondary osteoporosis in children, youth, and young adults: a systematic review and meta-analysis.

Hyunwoo Kim, Xiaomei Yao, Oliver Li, Megan Cheng, Moonbae Ahn, Jinhui Ma, Leanne M Ward

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Hyunwoo KimDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada.ORCID http://orcid.org/0000-0001-5478-5307
Xiaomei YaoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada.
Oliver LiDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada.
Megan ChengSchulich School of Medicine & Dentistry, Western University, Windsor, ON, N9B 2Y9, Canada.
Moonbae AhnDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
Jinhui MaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada. maj26@mcmaster.ca.
Leanne M WardDepartment of Pediatrics, Faculty of Medicine, Division of Endocrinology and Metabolism, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada. lward@cheo.on.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic illnesses and their treatments in childhood pose significant risks of bone fragility due to osteoporosis. Bisphosphonates (BP) are commonly used for treatment, yet evidence remains limited and heterogeneous. This systematic review aims to consolidate current empirical evidence on BP efficacy and safety in children, youth and young adults aged ≤ 21 years with secondary osteoporosis. Ovid MEDLINE and EMBASE, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, and Cochrane Central Register of Controlled Trials were searched by May 29th, 2025. This review followed the PRISMA guidelines the GRADE approach. This review was registered at PROSPERO (CRD42021242156). Seventeen studies were included (fifteen randomized controlled trials (RCTs), two quasi-RCTs) evaluating BP. Meta-analysis indicated that BP improved lumbar spine bone mineral density (BMD) z-score (mean difference (MD): 0.67; 95% confidence interval (CI): 0.37, 0.97) and lumbar spine bone mineral content (BMC) (MD: 2.90 g; 95% CI: 0.91, 4.90). There were no studies adequately powered to assess vertebral and non-vertebral fractures. Patient-reported outcomes showed no consistent results. Adverse events (AEs) were comparable between treatment and control groups (relative risk (RR): 1.08; 95% CI: 0.94, 1.23). When limited to short-term periods after the first infusion, AEs were more likely in the treatment group (RR: 2.24; 95% CI: 1.22, 4.11). BP treatment benefits pediatric secondary osteoporosis by improving lumbar spine BMD and BMC. However, small sample sizes and heterogeneity among the study methods continue to challenge the reliability of results, and larger RCTs are needed to assess fracture rates.

Indexed as

Bone Density Conservation AgentsDiphosphonatesOsteoporosisAdolescentBone DensityChildHumansLumbar VertebraeOsteoporotic FracturesRandomized Controlled Trials as TopicYoung AdultBone Density Conservation AgentsDiphosphonatesBisphosphonatesChronic illnessesSecondary osteoporosis

Identifiers

PMID41591403

What OpenQuestion holds

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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.