SynthesisFrontiers in endocrinology2025
Comparative efficacy and safety of anti-osteoporotic therapies for kidney transplant recipients: a systematic review and network meta-analysis.
Synthesis in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Mineral and Bone Disease in CKD and Kidney Transplantation: Controversies, Gaps, and a Path Forward.Kidney international reports · 2026Review
- Common Gynecologic Issues in Patients Post-Kidney Transplantation.Clinical transplantation · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Kidney transplant recipients (KTRs) are at an increased risk of osteoporosis, which negatively impacts their quality of life and transplant outcomes. However, the efficacy and safety of anti-osteoporosis treatments in this group remain uncertain. Methods: We conducted a systematic search of PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to August 1, 2024. Randomized controlled trials (RCTs) examining anti-osteoporotic medications in KTRs were included. Primary outcomes were changes in bone mineral density (BMD) at femoral neck and lumbar spine, and adverse events. We performed a frequentist network meta-analysis using random-effects models. Evidence certainty was assessed using the GRADE approach. Results: Twenty-one RCTs involving 1,066 participants were included, published between 2000 and 2021. For femoral neck BMD, bisphosphonates significantly improved BMD compared to control (MD = 0.04, 95%CI=0.00-0.09, p<0.05) based on low certainty evidence, while calcitonin was significantly superior to calcium (MD=-0.14, 95%CI=-0.28 to -0.01). Most other comparisons showed no statistically significant differences based on very low to moderate certainty evidence. For lumbar spine BMD, bisphosphonates, calcitonin, and calcium demonstrated statistically significant inferiority compared to denosumab, with bisphosphonates showing MD=-4.98 (95%CI=-6.84 to -3.13), calcitonin showing MD=-4.35 (95%CI=-6.24 to -2.47), and calcium showing MD=-5.85 (95%CI=-7.72 to -3.98), while denosumab was superior to control (MD = 5.10, 95%CI=3.25-6.95), based on low to very low certainty evidence from one RCT. Calcitonin was also significantly superior to calcium (MD = 0.60, 95%CI=0.07-1.12). For safety outcomes, no statistically significant differences were observed between interventions based on low to moderate certainty evidence. Conclusion: Denosumab appears most effective for improving lumbar spine BMD in KTRs, while calcitonin shows promise for femoral neck BMD improvement. However, the low to moderate certainty of evidence necessitates individualized treatment approaches considering patient-specific factors including renal function and safety profiles. These findings suggest current guidelines emphasizing bisphosphonates as first-line therapy may require revision, though larger long-term studies with fracture endpoints are needed to confirm these results. Systematic review registration: https://www.crd.york.ac.uk/prospero/?utm_source=chatgpt.com, identifier PROSPERO CRD42024587203.
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Registered trials
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.