Osteoporosis, bone & mineral

Impact of anti-osteoporosis medication on refracture prevention following osteoporotic vertebral fracture: a systematic review and meta-analysis

Osteoporos IntPublished Systematic review and meta-analysis

Authors' conclusion

Teriparatide may be considered a preferred option for secondary fracture prevention in patients with OVFs.

Study context

Population
Adult patients with existing osteoporotic vertebral fractures33 studies
Comparison
Anti-osteoporosis medications vs control or each other
Outcome
Refracture prevention (subsequent vertebral fracture)
Methodological detailsPRISMA
  • PRISMA

Pooled result

As reported in the abstract

Subsequent vertebral fracture (VF) rates
Odds ratio (95% CI)
Bisphosphonatesvs Control1 year
0.29(0.20–0.43)
Bisphosphonatesvs Control3 years
0.51(0.42–0.62)
Bisphosphonatesvs Controlfinal follow-up
0.35(0.26–0.48)
Teriparatidevs Control
0.39(0.16–0.97)
Teriparatidevs Bisphosphonates
0.41(0.30–0.56)
Romosozumabvs Bisphosphonatespatients undergoing vertebral augmentation
0.21(0.09–0.51)

Further pooled results

OutcomeEstimate
BMD percent changeBisphosphonatesvs Control1 yearMD 3.65 (95% CI 2.63–4.67)
BMD percent changeBisphosphonatesvs Control2 yearsMD 5.39 (95% CI 3.87–6.92)
BMD percent changeBisphosphonatesvs Control3 yearsMD 5.44 (95% CI 4.38–6.51)
VAS scoresBisphosphonatesvs Control6 monthsMD −0.41 (95% CI −0.67 to −0.14)
VAS scoresBisphosphonatesvs Control12 monthsMD −0.92 (95% CI −1.25 to −0.59)
VAS scoresTeriparatidevs Bisphosphonates3 monthsMD −1.41 (95% CI −2.47 to −0.35)
ODI scores · 12 monthsBisphosphonatesvs ControlSMD −1.89 (95% CI −3.07 to −0.71)
RMDQ scores · 3 monthsVitamin Dvs ControlMD −1.59 (95% CI −2.88 to −0.31)

Original publication

Impact of anti-osteoporosis medication on refracture prevention following osteoporotic vertebral fracture: a systematic review and meta-analysis. Osteoporos Int. Published 22 August 2025. doi:10.1007/s00198-025-07661-4

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