Osteoporosis Drugs Assessed for Secondary Fracture Prevention

Studies on whether osteoporotic drugs are effective in preventing secondary fractures have been limited
Studies on whether osteoporotic drugs are effective in preventing secondary fractures have been limited

Findings from a meta-analysis which assessed the ability of anti-osteoporotic drugs in preventing secondary fractures has been published in the journal Osteoporosis International.

Patients who have had an osteoporotic fracture are at higher risk of secondary fracture, yet studies on whether osteoporotic drugs are effective in preventing these subsequent fractures are limited. To examine the efficacy of these treatments, researchers from the University of Michigan searched randomized controlled trials that showed the incidence of secondary fractures while patients were taking anti-osteoporotic treatments (ie, bisphosphonates, selective estrogen receptor modulators, parathyroid hormone (PTH), or calcitonin); twenty-six studies were included in the analysis.

Results showed a significant reduction in the risk for secondary vertebral fracture with all of the of anti-osteoporotic drugs (risk ratio [RR] 0.38–0.77). Bisphosphonates significantly reduced the risk of secondary fractures (RR 0.59) with the number needed to treat (NNT) to prevent secondary fractures being 74. Treatment with PTH reduced the risk for both secondary vertebral (RR 0.38) and non-vertebral fractures (RR 0.64). In addition, the NNT for PTH to prevent secondary vertebral fracture was the lowest at 56. Overall, bisphosphonates and PTH were found to be most effective for preventing non-vertebral fractures.

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While more studies are needed to reveal the effectiveness of these agents on preventing secondary fractures, based on this study, the authors suggest that "clinicians who treat osteoporotic fractures should prescribe these drugs to prevent secondary vertebral or non-vertebral fractures." 

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