Bisphosphonate therapy for over an year may prevent fractures in postmenopausal women with osteoporosis: JAMA

USA: A recent study in JAMA Internal Medicine has suggested that bisphosphonate therapy is most likely to benefit women with osteoporosis having a life expectancy greater than 12.4 months. 

The meta-analysis found that the time to benefit (TTB) of bisphosphonate therapy was 12.4 months for preventing 1 nonvertebral fracture per 100 postmenopausal women with osteoporosis. 

The clinical decision for the initiation of bisphosphonate therapy for osteoporosis treatment requires balancing shorter-term harms and burdens (eg, severe musculoskeletal pain or gastroesophageal irritation) with longer-term benefits for reducing potential fractures. William James Deardorff, University of California, San Francisco, and colleagues, therefore, aimed to assess the time to benefit of bisphosphonate therapy for the prevention of nonvertebral and other fractures among postmenopausal women with osteoporosis in a meta-analysis of 10 randomized clinical trials.

For this purpose, the researchers identified randomized clinical trials (RCTs) involving postmenopausal women with a diagnosis of osteoporosis based on existing vertebral fractures or bone mineral density T scores of −2.5 or lower. The selection process was focused on studies of alendronate, risedronate, and zoledronic acid because they are guideline-recommended first-line agents for reducing nonvertebral fractures.