Pre-treatment bone mineral density and the benefit of pharmacologic treatment on fracture risk and BMD change: analysis from the FNIH-ASBMR SABRE project
Authors' conclusion
In summary, anti-osteoporotic medications reduced the risk of fractures regardless of baseline BMD. Significant fracture risk reduction with treatment for 4 of the 5 fracture endpoints was seen in participants with T-scores above -2.5, though effects tended to be larger and more significant in those with baseline T-scores <-2.5.
Study context
- Population
- Participants of 25 randomized controlled trials (RCTs) of osteoporosis medications (FNIH-ASBMR SABRE project); 42% had FN BMD T-score ≤ −2.5
- Participants
- 103,086 participants25 RCTs
- Comparison
- Anti-osteoporosis drugs vs control, by baseline FN BMD T-score
- Outcome
- Anti-fracture efficacy of treatment according to baseline BMD (clinical fracture outcomes; radiographic vertebral fracture)
Methodological detailssubgroup analysis, FNIH-ASBMR SABRE project, Cox proportional hazard regression, logistic regression, BMD quintile analysis
- Subgroup analysis
- FNIH-ASBMR SABRE project
- Cox proportional hazard regression
- Logistic regression
- BMD quintile analysis
Pooled result
As reported in the abstract
Treatment effect on fractures by FN BMD T-score subgroup
- Significant fracture reductions with treatment in both T-score ≤ −2.5 and > −2.5 subgroups
- Risk reduction greater with T-score ≤ −2.5 for each fracture outcome; only all-fracture outcome significant
- T-score ≤−2.5 vs T-score > −2.5: interaction P = .001
Further pooled results
Bisphosphonate trials only
- Results similar when limited to bisphosphonate trials
BMD quintile analysis
- Greater reduction of non-vertebral, all and all clinical fractures in lower BMD quintiles
- all interaction P ≤ .03
- Significant anti-fracture efficacy across all quintiles for vertebral fractures
Original publication
Pre-treatment bone mineral density and the benefit of pharmacologic treatment on fracture risk and BMD change: analysis from the FNIH-ASBMR SABRE project. J Bone Miner Res. Published 1 May 2024. doi:10.
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