- A meta-analysis of 38 randomised controlled trials finds no association between drug therapy for osteoporosis and lower overall mortality.
Why this matters
- Observational studies have supported an association with reduced mortality, but are not as methodologically strong and may not have adequately controlled for confounders.
- Authors recommend that osteoporosis therapy, especially bisphosphonates, be reserved for reducing fracture risk.
- Meta-analysis of 38 randomised trials with a duration ≥1 year (n=101,642 participants) after a search of Science Direct, MEDLINE, Embase, and Cochrane Library.
- Funding: None disclosed.
- No association between osteoporosis drug therapy (vs placebo) and overall mortality (risk ratio [RR], 0.98; 95% CI, 0.91-1.05), with no evidence of heterogeneity (I2=0%).
- Findings supported in subgroup analysis:
- Bisphosphonates (RR, 0.95; 95% CI, 0.86-1.04).
- Zoledronate (RR, 0.88; 95% CI, 0.68-1.13; I2=48.2%).
- Alendronate (RR, 1.00, 95%, CI 0.71-1.40)
- No association observed even with treatment duration ≥3 years (RR, 0.97; 95% CI, 0.88-1.08).
- High heterogeneity in zoledronate subanalysis.
- No trials of odanacatib have been published beyond abstract results.