Pharmacological therapies for the prevention of fractures in men.
Lars Christian Braten, Cyrill Suter, Renea V Johnston et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of pharmacological therapies for fracture prevention in men aged 50 and older, focusing on bisphosphonates, PTH analogues, denosumab, and romosozumab. The analysis included 17 trials with 4132 participants. The results indicated very low certainty regarding the impact of bisphosphonates on hip fractures, with a risk ratio of 0.73 compared to placebo.
Key findings
- 2/875 participants in the bisphosphonate group reported hip fractures compared to 2/760 in the placebo group (RR 0.73).
- 5/1021 participants in the bisphosphonate group had symptomatic vertebral fractures compared to 7/855 in the placebo group (RR 0.49).
- 25/1130 participants in the bisphosphonate group reported other fractures compared to 19/913 in the placebo group (RR 0.78).
Why it matters
Understanding the effectiveness of fracture prevention therapies in men is crucial, as most osteoporosis research has focused on women. This review highlights the need for more targeted studies to inform clinical decisions regarding fracture prevention in older men.
What to keep in mind
The review noted high susceptibility to bias in many trials and downgraded the certainty of evidence due to imprecision and potential publication bias.