Table 6Fracture Outcomes of Placebo-controlled Primary Prevention Trials*

MedicationType of Fracture
VertebralNonvertebralHipWristAnkle
Risk ratio (95% CI)No. trialsRisk ratio (95% CI)No. trialsRisk ratio (95% CI)No. trialsRisk ratio (95% CI)No. trialsRisk ratio (95% CI)No. trials
Bisphosphonates
Alendronate0.60 (0.44–0.83)47, 50, 14130.88 (0.55–1.40)50, 142, 14330.78 (0.44–1.38)50, 14320.76 (0.27–2.16)50, 14320.40 (0.08–2.07)1431
Combined bisphosphonates0.66 (0.50–0.89)47, 50, 141, 145-14870.83 (0.64–1.08)50, 142, 143, 145-15090.70 (0.44–1.11)41, 50, 14330.67 (0.25–1.82)50, 143, 14930.33 (0.08–1.44)143, 1492
Parathyroid hormone
Women: 0.32 (0.14–0.75)151
Men: 0.49 (0.22–1.09)159
Women: 1
Men: 1
Women: 0.97 (0.71–1.33)151
Men: 0.51 (0.10–2.48)159
Women: 1
Men: 1
No evidenceNo evidenceNo evidence
Raloxifene
0.61 (0.54–0.69)152, 15420.97 (0.87–1.09)154, 23320.97 (0.62–1.52)15210.83 (0.66–1.05)15210.94 (0.60–1.47)1521
Estrogen
Estrogen with progestin0.66 (0.46–0.92)1571No evidence0.67 (0.47–0.96)15710.71 (0.69–0.85)15710.71 (0.69–0.85)1571
Estrogen alone§0.62 (0.42–0.93)1581No evidence0.61 (0.41–0.91)1581No evidenceNo evidence

Abbreviation: CI = confidence interval.

*

Results for postmenopausal women unless otherwise indicated.

Data presented with nominal CIs; adjusted CI for hip (0.41–1.10) and not provided for other sites.

Clinical vertebral fractures.

§

Data presented with nominal CIs; adjusted CIs include: vertebral (0.34–1.13), hip (0.33–1.11).

Results for postmenopausal women unless otherwise indicated.

Data presented with nominal CIs; adjusted CI for hip (0.41–1.10) and not provided for other sites.

Clinical vertebral fractures.

Data presented with nominal CIs; adjusted CIs include: vertebral (0.34–1.13), hip (0.33–1.11).

From: 3, Results

Cover of Screening for Osteoporosis
Screening for Osteoporosis: Systematic Review to Update the 2002 U.S. Preventive Services Task Force Recommendation [Internet].
Evidence Syntheses, No. 77.
Nelson HD, Haney EM, Chou R, et al.

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