Evidence mapPaperPMID 40195141Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis.

Hui Zhen Lo, Kevin Leow, Rachael Hii, Nitesh Nerlekar, Peter R Ebeling, Alexander J Rodríguez

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. 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

6 authors.

Hui Zhen LoPeninsula Health, 2 Hastings Road, Frankston, VIC, 3199, Australia.
Kevin LeowDepartment of Cardiology, Canberra Hospital, Woden, Yamba Dr, Garran, Australian Capital Territory, 2605, Australia.
Rachael HiiDepartment of Medicine, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
Nitesh NerlekarDepartment of Medicine, Monash Health, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
Peter R EbelingDepartment of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
Alexander J RodríguezDepartment of Medicine, School of Clinical Sciences at Monash Health, Bone and Muscle Health Research Group, Monash University, Monash Medical Centre Block E, Level 5, 246 Clayton Rd, Clayton, VIC, 3168, Australia. Alexander.Rodriguez@monash.edu.ORCID http://orcid.org/0000-0002-2955-0642

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveVascular calcification shares many features with skeletal mineralisation and shares an inverse relationship with osteoporosis (skeletal de-mineralisation). However, medications that reduce bone loss (anti-resorptives) have had inconsistent effects on extra-skeletal mineralisation (i.e. vascular and valvular calcification). As such, this paper aims to synthesise existing literature examining the effect of anti-resorptive treatments on extra-skeletal (vascular and valvular) calcification across populations.

methodsMedline and Embase were searched (inception to October 2024) for studies that assessed the association between anti-resorptive medication use and vascular/valvular calcification. Pooled standardised mean differences (SMDs) with 95% confidence intervals (CI) were calculated for all outcomes, using random-effects model. Leave-one-out sensitivity analyses were performed for internal validity.

resultsOf 4071 articles screened, 33 were included in the review, and 15 (2344 participants) had data available for meta-analysis. Anti-resorptive use was associated with non-significant, small magnitude improvements in abdominal aortic calcification (decreased value), coronary artery calcification (decreased value) and ejection fraction (increased value) but significant small reduction in aortic valve area (representing less calcification on the valve) with standardised mean difference of - 0.45 (95% confidence interval (CI) - 0.99; 0.08, I

conclusionThe significance of small positive effect of anti-resorptives on aortic stenosis is clinically uncertain. Despite strong biological links between vascular calcification and skeletal mineralisation, anti-resorptives do not appear to have a strong favourable influence on extra-skeletal mineralisation. This suggests that mechanisms that link vascular calcification with osteoporosis may be acting in pathways not influenced by anti-resorptives. This systematic review and meta-analysis summarises the effect of anti-resorptives on vascular and valvular calcification. There is a small, positive effect of anti-resorptives on aortic stenosis, though this is of uncertain clinical importance.

Indexed as

Bone Density Conservation AgentsHeart Valve DiseasesOsteoporosisVascular CalcificationHumansBone Density Conservation AgentsAnti-resorptiveOsteoporosisVascular calcification

Identifiers

PMID40195141
PMCPMC12089254

What Socratic holds

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Registered trials

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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.