Osteoporosis Medications: Not All They’re Cracked Up to Be

The quality of evidence for osteoporosis treatment varies across drug classes and clinical outcomes. For example, hip fracture risk reduction with bisphosphonates is modest (<1% over 3 years) and less certain for other drug classes. To assess the overall robustness of existing evidence, researchers identified 27 randomized trials of osteoporosis medications published in 11 high-impact journals. They then used a novel approach to assess the number of additional fractures that would be required in each intervention group to render the results statistically insignificant (i.e., to nullify the benefit of the medications). Outcomes varied across trials and included osteoporotic, hip, and vertebral fractures.