SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026
Effectiveness and safety of bone protective interventions to mitigate bone loss and skeletal fractures experienced by patients with non-metastatic breast cancer: a systematic review and meta-analysis.
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. Cited by 1 paper.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Author response to OSIN-D-26-00399 bone protection in breast cancer: durability and discontinuation.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cancer treatment-induced bone loss (CTIBL) and skeletal fractures are potential consequences of anticancer therapies used in the treatment of non-metastatic breast cancer (BC). This systematic review and meta-analysis aim to synthesise the available evidence regarding the effectiveness and safety of bone protective interventions in the mitigation of CTIBL and skeletal fractures. Multiple databases including MEDLINE/PubMed, Embase and Cochrane, clinical trial registries and grey literature were systematically searched for experimental and observational studies, investigating the use of bisphosphonates, denosumab, calcium or vitamin D supplementation. Outcomes of interest were change in bone mineral density (BMD), the incidence of skeletal fractures, change in bone turnover markers, the incidence of adverse events (AEs), the presence of aromatase inhibitor musculoskeletal symptoms and quality of life. A total of 88 studies were included in our systematic review and meta-analysis, with sample sizes ranging from 11 to 4819 participants. For change in BMD outcomes able to be meta-analysed, bisphosphonates demonstrated a significant benefit compared to controls (pooled mean difference estimate; lumbar spine: 4.17, p = 0.0; total hip: 1.81, p = 0.034; femoral neck: 2.35, p = 0.001). Incidence of skeletal fractures significantly decreased with bisphosphonates compared to controls (pooled relative risk estimate; 0.77, p < 0.001). Denosumab demonstrated similar effects on BMD and skeletal fracture incidence; however, meta-analysis was not possible due to the lack of randomised controlled trials. Osteonecrosis of the jaw represents the most concerning AE with bisphosphonates. Considering the effectiveness and safety, and the level of evidence available, bisphosphonates present as the preferred bone protective intervention for the management of bone health in patients with non-metastatic BC.
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