Influence of age on the efficacy of pharmacologic treatments on fracture risk reduction and increases in BMD: RCT results from the FNIH-ASBMR-SABRE project
Authors' conclusion
In summary, anti-osteoporotic medications similarly reduced the risk of fractures regardless of age, and the few small differences in fracture risk reduction by age were of uncertain clinical significance.
Study context
- Population
- Participants in 23 randomized controlled trials (RCTs) of osteoporosis medications (99% female); 43% aged ≥70 yr
- Participants
- 123,164 participants23 RCTs
- Comparison
- Anti-osteoporosis drugs vs control, by age subgroup
- Outcome
- Anti-fracture efficacy (radiographic vertebral, non-vertebral, hip, all clinical and all fractures) and BMD effect by age subgroup
Methodological detailssubgroup analysis by age, FNIH-ASBMR SABRE project, 23 RCTs
- Subgroup analysis by age
- FNIH-ASBMR SABRE project
- 23 RCTs
Pooled result
As reported in the abstract
Fracture risk reduction by age subgroup
| Group | OR vertebral fractures | HR all fractures |
|---|---|---|
| <70 yr | 0.47 | 0.72 |
| ≥70 yr | 0.51 | 0.70 |
OR vertebral fractures
<70 yr0.47
≥70 yr0.51
HR all fractures
<70 yr0.72
≥70 yr0.70
- Between <70 yr and ≥70 yr: interaction P = .19
- Between <70 yr and ≥70 yr: interaction P = .20
Further pooled results
| Outcome | <70 yr | ≥70 yr | P value |
|---|---|---|---|
| Hip fracture, bisphosphonate trials onlyRisk reduction somewhat greater in <70 yr | interaction P = .02 | ||
| HR | 0.44 | 0.79 |
Hip fracture, bisphosphonate trials only
- Other results similar when limited to bisphosphonate trials
Hip and spine BMD change · 24 mo
- Significantly greater increases in hip and spine BMD in ≥70 vs <70 yr
Original publication
Influence of age on the efficacy of pharmacologic treatments on fracture risk reduction and increases in BMD: RCT results from the FNIH-ASBMR-SABRE project. J Bone Miner Res. Published 19 March 2024. doi:10.
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