Evidence map›Paper›PMID 30607457›Full record

Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019

Mortality risk reduction differs according to bisphosphonate class: a 15-year observational study.

D Bliuc, T Tran, T van Geel, J D Adachi, C Berger, J van den Bergh, J A Eisman, P Geusens, D Goltzman, D A Hanley and 8 more

Open access · greenAbstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 36 citations in OpenAlex.

  1. Article
  2. From Bone Health to Lifespan: Pleiotropic Effects of Antiresorptive Agents.Endocrinology and metabolism (Seoul, Korea) · 2025
    Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Impact of osteoporotic fracture type and subsequent fracture on mortality: the Tromsø Study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
  11. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 12 institutions in 5 countries.

D BliucOsteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia. d.bliuc@garvan.org.au.ORCID http://orcid.org/0000-0001-9682-2313
T TranOsteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.
T van GeelMaastricht University Medical Center, Research School CAPHRI, Care and Public Health Research Institute, Maastricht, The Netherlands.
J D AdachiDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
C BergerCaMos National Coordinating Centre, McGill University, Montreal, Quebec, Canada.
J van den BerghResearch School Nutrim, Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.
J A EismanOsteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.
P GeusensMaastricht University Medical Center, Research School CAPHRI, Care and Public Health Research Institute, Maastricht, The Netherlands.
D GoltzmanDepartment of Medicine, McGill University, Montreal, Quebec, Canada.
D A HanleyDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.
R G JosseDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
S KaiserDepartment of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
C S KovacsFaculty of Medicine, Memorial University, St. John's, Newfoundland, Canada.
L LangsetmoSchool of Public Health, University of Minnesota, Twin Cities, Minneapolis, MN, USA.
J C PriorDepartment of Medicine and Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada.
T V NguyenOsteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.
J R CenterOsteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.
CaMOS Research Group
Maastricht University · NLGarvan Institute of Medical Research · AUMcGill University · CADalhousie University · CAMcMaster University · CAMemorial University of Newfoundland · CAThe University of Sydney · AUUniversity of British Columbia · CAUniversity of Calgary · CAUniversity of Minnesota · USUniversity of Technology Sydney · AUUniversity of Toronto · CA

Funding

National Health and Medical Research Council 1008219National Health and Medical Research Council 1070187
6 · The paper itself

Abstract

In this prospective cohort of 6120 participants aged 50+, nitrogen-bisphosphonates but not non-nitrogen bisphosphonates were associated with a significant 34% mortality risk reduction compared to non-treated propensity score matched controls. These findings open new avenues for research into mechanistic pathways.

introductionEmerging evidence suggests that bisphosphonates (BP), first-line treatment of osteoporosis, are associated with reduced risks for all-cause mortality. This study aimed to determine the association between different BP types and mortality risk in participants with or without a fracture.

methodsA prospective cohort study of users of different BPs matched to non-users by propensity score (age, gender, co-morbidities, fragility fracture status) and time to starting the BP medication from the population-based Canadian Multicentre Osteoporosis Study from nine Canadian centres followed from 1995 to 2013. Mortality risk for bisphosphonate users vs matched non-users was assessed using pairwise multivariable Cox proportional hazards models.

resultsThere were 2048 women and 308 men on BP and 1970 women and 1794 men who did not receive medication for osteoporosis. The relationship between BP and mortality risk was explored in three separate 1:1 propensity score-matched cohorts of BP users and no treatment (etidronate, n = 599, alendronate, n = 498, and risedronate n = 213). Nitrogen BP (n-BP) (alendronate and risedronate) was associated with lower mortality risks [pairwise HR, 0.66 (95% CI, 0.48-0.91)] while the less potent non-n-BP, etidronate, was not [pairwise HR: 0.89 (95% CI, 0.66-1.20)]. A direct comparison between n-BP and etidronate (n = 340 pairs) also suggested a better survival for n-BP [paired HR, 0.47 (95%CI, (95% CI, 031-0.70)] for n-BP vs. etidronate].

conclusionCompared to no treatment, nitrogen but not non-nitrogen bisphosphonates appear to be associated with better survival.

Indexed as

AgedAlendronateBone Density Conservation AgentsCanadaDiphosphonatesEtidronic AcidFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMiddle AgedOsteoporosisOsteoporotic FracturesProspective StudiesRisedronic AcidAlendronateBone Density Conservation AgentsDiphosphonatesEtidronic AcidRisedronic AcidBisphosphonateFractureMortality riskOsteoporosisProspective study

Identifiers

PMID30607457
OpenAlexW2908225316

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.