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Osteoporosis treatment

Osteoporosis treatment has been studied in 21 papers since 2016: 16 observational studies in people, 3 reviews. It has not reached trials in people. The newest paper, Oct 22, 2025: “OR10-06 Mortality and Hospitalization Outcomes in Patients Aged 80 and Older Receiving Osteoporosis Treatment After Fracture”.

InterventionPreclinical

21 papers study it19 findingsUpdated

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“fracture and mortality rates were 36.9 and 280.9 per 1000 patient-years, respectively; higher in non-treated versus treated (39.3 versus 24.0 and 303.7 versus 126.7) patients.”
Burden of Disease and Treatment Gap in Patients with an Osteoporotic Hip Fracture between 2015 and 2019 in ItalyDrugs & aging2025doi:10.1007/s40266-025-01211-7

2 of its findings point the other way.

C, W, M, H: cells, worms or flies, mice, humans. Dark: independent labs found the same change there. Light: one lab or one study. Outline: nothing yet.

Labs are independent when their papers share no last author and no institution.

Against: findings that point the other way from most findings on the same outcome.

Company ties: findings with an author at a company, or from a paper whose competing-interests statement declares ties to one.

  • 12 independent labs in 8 countries
  • 2 findings against
  • Funders: Amgen and others
  • 4 of 16 findings with company ties
  • Humans16
  • In silico2

What did studies of Osteoporosis treatment find?

6

Studies of Osteoporosis treatment measured 6 outcomes; the most studied are mortality (3 studies), hospitalization (1) and ambulatory function (1).

Mortality

downin humans3OR 0.85

3 studies

  1. Osteoporosis treatment decreases mortality in humans (OR 0.850, 95% CI 0.825–0.876).

    “experienced lower all-cause mortality (11,073 vs 12,479 patients, OR 0.850, 95% CI 0.825, 0.876)”

    Humansosteoporotic fragility fracture5 years

    OR10-06 Mortality and Hospitalization Outcomes in Patients Aged 80 and Older Receiving Osteoporosis Treatment After Fracture

    ENDO 2025 abstract

  2. Osteoporosis treatment decreases mortality in humans (126.7 vs 303.7 per 1000 patient-years).

    “higher in non-treated versus treated (39.3 versus 24.0 and 303.7 versus 126.7) patients.”

    Humanspost-index osteoporotic hip fracture12 months

    Burden of Disease and Treatment Gap in Patients with an Osteoporotic Hip Fracture between 2015 and 2019 in Italy

    Drugs & aging

  3. Osteoporosis treatment decreases mortality in humans (HR 0.22, 95% CI 0.07-0.75, P=0.015).

    “The hazard ratio for the presence of osteoporosis treatment was 0.22 (95% confidence interval 0.07-0.75, P=0.015).”

    Humansfollowing periprosthetic femoral fracture after hemiarthroplasty for femoral neck fracturen = 156

    Addressing osteoporosis treatment after hemiarthroplasty for a femoral neck fracture: impact on survival rates after a subsequent periprosthetic femoral fracture - a multicenter (TRON group) retrospective study

    Archives of osteoporosis

Hospitalization

downin humans1OR 0.814

1 study

  1. Osteoporosis treatment decreases hospitalization in humans (OR 0.814, 95% CI 0.792–0.836).

    “had lower incidence of hospitalizations (18,142 vs 20,385 patients, with an odds ratio of 0.814 and 95% CI 0.792,0.836)”

    Humansosteoporotic fragility fracture5 years

    OR10-06 Mortality and Hospitalization Outcomes in Patients Aged 80 and Older Receiving Osteoporosis Treatment After Fracture

    ENDO 2025 abstract

Ambulatory function

upin humans1

1 study

  1. Osteoporosis treatment improves ambulatory function in humans (72.5% and 68.5% vs 43.7%, p = 0.0007).

    “The rate of regaining ambulatory function was also higher in the treatment groups (new: 29/40 (72.5%), pre-existing: 37/54 (68.5%)) compared with the non-treatment group (45/103 (43.7%)) (p = 0.0007).”

    Humansnew and pre-existing treatment vs non-treatment

    Efficacy of Osteoporosis Treatment in Nonagenarians With Proximal Femoral Fractures: A Retrospective Cohort Study

    Cureus

Secondary fracture

no changein humans1

1 study

  1. Osteoporosis treatment has no effect on secondary fracture in humans (30% vs 29%).

    “Unadjusted comparisons indicated that newly initiated treatment did not reduce secondary fracture risk”

    Humansnewly initiated treatment vs non-treatmentaverage follow-up of 4.4 yearsn = 247

    Efficacy of Osteoporosis Treatment in Nonagenarians With Proximal Femoral Fractures: A Retrospective Cohort Study

    Cureus

More on Secondary fracture

Physical function

downin humans1

1 study

  1. Osteoporosis treatment impairs physical function in humans (p < 0.05).

    “TG had a worse performance in the intrinsic factors in the MMSE, plantarflexions range of motion, gait speed, plantarflexions peak isometric strength, and short physical performance battery (p < 0.05 for all)”

    Humansin treatment for osteoporosis vs controlfemalesn = 128

    Physiological and Ankle Functions Are Discriminating Factors for the Risk of Falls in Women in Treatment of Osteoporosis

    International journal of environmental research and public health

Osteoporotic fracture

downin silico1

1 study

  1. Osteoporosis treatment prevents osteoporotic fracture in silico (4.4 M fractures prevented, saved US $13.5B).

    “Increased treatment scenario prevented 4.4 M fractures and saved US $13.5B.”

    In silicoincreased treatment scenario among postmenopausal women at highest risk2020 to 2040females

    Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in South Korea: a simulation projection model from 2020 to 2040

    Archives of osteoporosis

What is Osteoporosis treatment linked with?

6

Studies link Osteoporosis treatment with 6 measures, most often hip fracture (2 studies), secondary fracture (1) and mortality (1).

Hip fracture

downin humans2OR 0.26

2 studies

  1. Osteoporosis treatment lowers the risk of hip fracture in humans.

    “A large case-control observational study from 2024 did find that osteoporosis treatment reduced odds of hip fracture similarly in men and women.”

    Reviewmales

    Osteoporosis in Men: an Overlooked Patient Population

    Current osteoporosis reports

  2. Osteoporosis treatment lowers the risk of hip fracture in humans (OR 0.26 (95% CI 0.21-0.33)).

    “Odds ratio of hip fracture for treated vs not-treated was 0.26 (95% confidence interval: 0.21-0.33) for women”

    Humansosteoporosisprimarily with alendronate2-year follow-upfemalesn = 2,211

    Osteoporosis treatment prevents hip fracture similarly in both sexes: the FOCUS observational study

    Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research

More on Hip fracture

Secondary fracture

downin humans1

1 study

  1. Osteoporosis treatment lowers the risk of secondary fracture in humans (11% vs 30% and 29%, p = 0.009).

    “The incidence of secondary fractures was significantly lower in the pre-existing treatment group (7/64 (11%)) than in the new treatment (15/50 (30%)) and non-treatment (38/133 (29%)) groups (p = 0.009).”

    Humanspre-existing treatment vs non-treatment and new treatmentaverage follow-up of 4.4 yearsn = 247

    Efficacy of Osteoporosis Treatment in Nonagenarians With Proximal Femoral Fractures: A Retrospective Cohort Study

    Cureus

More on Secondary fracture

Mortality

upin humans1

1 study

  1. Osteoporosis treatment is associated with mortality in humans (37% 1-year mortality).

    “The 1-year mortality rate was 37%, with significant predictors including age, male gender, lack of prior osteoporosis treatment, delayed treatment initiation, and short treatment duration.”

    Humanship fracture1-yearn = 552

    Osteoporosis treatment gap after hip fracture: data from a tertiary center in Turkey

    Archives of osteoporosis

Osteoporotic fractures

downin humans1

1 study

  1. Osteoporosis treatment lowers the risk of osteoporotic fractures in humans (24.0 vs 39.3 per 1000 patient-years).

    “fracture and mortality rates were 36.9 and 280.9 per 1000 patient-years, respectively; higher in non-treated versus treated (39.3 versus 24.0 and 303.7 versus 126.7) patients.”

    Humanspost-index osteoporotic hip fracture12 months

    Burden of Disease and Treatment Gap in Patients with an Osteoporotic Hip Fracture between 2015 and 2019 in Italy

    Drugs & aging

More on Osteoporotic fractures

Vertebral fracture

downin humans1

1 study

  1. Osteoporosis treatment lowers the risk of vertebral fracture in humans.

    “with all the randomized controlled trials performed in men, there was only sufficient power to show vertebral fracture reduction”

    Reviewin menmales

    Osteoporosis in Men: an Overlooked Patient Population

    Current osteoporosis reports

More on Vertebral fracture

Vertebral fragility fracture

upin humans1

1 study

  1. Osteoporosis treatment is associated with vertebral fragility fracture in humans (9.9% vs 5.3%).

    “9.9% of the treated patients developed new vertebral fragility fractures, compared with 5.3% of the untreated patients.”

    Humanspostmenopausal womenbone2.5 yearsfemales

    Comparison between real-world practice and application of the FRAX algorithm in the treatment of osteoporosis

    Aging clinical and experimental research

More on Vertebral fragility fracture

What acts on Osteoporosis treatment?

4

Studies name 4 things that act on Osteoporosis treatment, most often internal medicine co-management program (1 study), fracture liaison service (1) and geriatrician involvement (1).

Internal medicine co-management program

upin humans1

1 study

  1. Internal medicine co-management program increases osteoporosis treatment in humans (87.8% vs. 60.7% and 42.4% vs. 15.7%, p < 0.001).

    “The prevalence of osteoporosis treatment, both calcium/vitamin D (87.8% vs. 60.7%, p < 0.001) and bisphosphonates/denosumab/teriparatide (42.4% vs. 15.7%, p < 0.001), was higher in the co-managed patients”

    Humanship fracture30 days postdischargen = 207

    Effectiveness of a co-management program with internal medicine on hip fracture patients at a regional hospital in northwest Spain. Co-inter-Monf study

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

More on Internal medicine co-management program

Fracture liaison service

upin humans1

1 study

  1. Fracture liaison service increases osteoporosis treatment in humans (8.1% vs 77.6%).

    “The FLS significantly increased the rate of OP treatment, when compared with standard clinical practice (8.1% vs 77.6%).”

    Humans3 yearsn = 551

    The impact of a Fracture Liaison Service after 3 years on secondary fracture prevention and mortality in a Portuguese tertiary center

    Archives of osteoporosis

More on Fracture liaison service

Geriatrician involvement

upin humans1OR 2.5

1 study

  1. Geriatrician involvement increases osteoporosis treatment in humans (OR 2.5, CI 2.4-2.7).

    “initiation of an osteoporosis treatment during in-hospital stay (OR 2.5, CI 2.4-2.7)”

    Humanship fracture patients requiring surgeryin-hospital stay72% femalesn = 23,828

    Increased Geriatric Treatment Frequency Improves Mobility and Secondary Fracture Prevention in Older Adult Hip Fracture Patients-An Observational Cohort Study of 23,828 Patients from the Registry for Geriatric Trauma (ATR-DGU)

    Journal of clinical medicine

More on Geriatrician involvement

Time

upin humans1

1 study

  1. time increases osteoporosis treatment in humans (from 39.1% in FY2012 to 65.5% in FY2022).

    “The medication administration rate within the first year following the primary fracture progressively increased over time, from 39.1% in FY2012 to 49.6% in FY2021, followed by a notable increase to 65.5% in FY2022.”

    Humans1 year

    Trends in the incidence of secondary hip fractures and osteoporosis treatment in Japan (FY2012-FY2023)

    Journal of bone and mineral metabolism

Funding

11 grants since 2018

Japan Society for the Promotion of ScienceJP¥13.9mInnovative UK£541.8kFundação para a Ciência e a Tecnologia

Latest

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