Does Osteoporosis Treatment Reduce Overall Mortality in Addition to Fracture Risk?

According to a recent meta-analysis, no significant association was observed between pharmacotherapies used for osteoporosis treatment and mortality rate, despite previous studies suggesting the treatments, particularly bisphosphonates, lower overall mortality.

To investigate this association, study authors searched various databases and conference abstracts for randomized placebo-controlled studies in which drug therapies were evaluated for a year or more at a dose approved for osteoporosis treatment. They identified 38 studies that fit the inclusion criteria; 21 studies involved bisphosphonate treatments (22,623 for treatment vs 20,244 for placebo), with 6 trials assessing zoledronate (6926 for treatment vs 6944 for placebo).

Results showed that osteoporosis drugs were not associated with reduced overall mortality rates (risk ratio [RR], 0.98; 95% CI, 0.91-1.05; I2= 0%); studies evaluating bisphosphonate treatments specifically produced similar results (RR, 0.95; 95% CI, 0.86-1.04). “Clinical trials of zoledronate treatment (RR, 0.88; 95% CI, 0.68-1.13) showed no association with overall mortality rate; however, evidence existed for heterogeneity of the results (I2 = 48.2%),” the authors reported.

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Based on their findings, the authors concluded that osteoporosis treatment should only be recommended to prevent fracture and not for reducing mortality risk. They added that “additional trials are needed to clarify whether treatment with zoledronate reduces mortality rates.”

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