Osteoporosis Treatment Options: A Super Speedy Review

Unlock the secrets to effective osteoporosis treatment in this super speedy review from the Dr Journal Club podcast. Dr. Joshua Goldenberg highlights key medications from a recent BMJ systematic review and network meta-analysis. Discover why PTH agonists are the most effective for preventing clinical fractures in postmenopausal women and see how other medications compare.

With over 80,000 women in 69 randomized controlled trials, the study offers crucial insights into the efficacy and safety of various osteoporosis medications, with no significant harm outcomes reported. Whether you're a healthcare professional or a concerned family member, this episode is packed with valuable information. Don't miss the basic and in-depth versions of the review available on our platform!

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Episode Transcript

Introducer (00:02):
Welcome to the Dr Journal Club podcast, the show
that goes under the hood ofevidence-based integrative
medicine.
We review recent researcharticles, interview
evidence-based medicine thoughtleaders and discuss the
challenges and opportunities ofintegrating evidence-based and
integrative medicine.
Continue your learning afterthe show at www.

(00:23):
d rjournalclub.
com.

Dr. Joshua Goldenberg (00:31):
Please bear in mind that this is for
educational and entertainmentpurposes only.
Talk to your doctor beforemaking any medical decisions,
changes etc.
Everything we're talking aboutthat's to teach you guys stuff
and have fun.
We are not your doctors.
Also, we would love to answeryour specific questions on
drjournalclubcom.
You can post questions andcomments for specific videos,

(00:55):
but go ahead and email usdirectly at josh at
drjournalclub.
com.
That's josh at drjournalclub.
com.
Send us your listener questionsand we will discuss it on our
pod.
Hello and welcome to anothersuper speedy summary.
This is your host, dr JoshuaGoldenberg.

(01:16):
Today we're going to talk aboutwhat works for osteoporosis.
This was a very recentsystematic review and network
meta-analysis in my favoritejournal, the BMJ.
Dr Adam Sadowski goes intodetailed review of the study in
the basic level and in-depthlevel version of this study, but
today we're going to just coverthe highlights here.
So osteoporosis is common.

(01:38):
Unfortunately, fractures areextremely concerning to patients
and their families.
People who are newly diagnosedare often terrified about you
know are they going to breaktheir backs, are they going to
be able to pick up theirgrandchildren, etc.
Etc.
Things that have just takesover the psyche of those newly
diagnosed and it's going to bequite concerning for patients

(01:59):
and their fam.
And alongside these concerns,the number of medications for
osteoporosis has expandedrecently and randomized
controlled trials haveproliferated.
Now, when you have multiplerandomized controlled trials
that use you know, some useplacebos, some use active
comparators etc it becomesreally clear if you stack them
against each other which onesare the best, and that's really

(02:22):
where network meta-analysesthrive.
So the question is you knowwhat are the most effective and
that's really where networkmeta-analyses thrive.
So the question is you knowwhat are the most effective and
safe osteoporosis medications toprevent fractures, which is the
most clinically importantoutcome in those with
osteoporosis.
So, like I said, this was anetwork meta-analysis.
They had 69 randomizedcontrolled trials, over 80,000
patients, and these were all inpostmenopausal women and they

(02:44):
took any study that used anytype of OP osteoporosis
medication in any comparator,including placebo.
And the beautiful thing aboutnetwork meta-analyses is it can
kind of create this network andtell you well, if this
intervention would have beenstudied against that
intervention, what is theoverall effect.
And they're able to say thatthrough these shared comparators

(03:06):
.
And if you want to learn moreabout that, we've got a bunch of
videos on this in Dr JournalClub and they were looking
primarily at all fractures,clinical fractures as well as
secondary outcomes, includingspecific fractures such as
vertebral fractures, as well asharm outcomes.
So what did they find?
So, for clinical fractures,they basically found that the
bisphosphonates, so everythingkind of worked.

(03:26):
It was all more effective whencompared to placebo, but the PTH
agonists were going to be themost effective there.
As far as vertebral fractures,which is what most people are
very concerned about, again, allwere effective compared to
placebo, but the bisphosphonatesperformed less or least well, I
guess, compared to the otherintervention classes, and no

(03:49):
harm outcomes were seen.
So if you'd like to see moredetail on this study, go ahead
and watch the basic and in-depthlevel versions done by the
amazing Dr Adam Sadowski.
See you next time.
If you enjoy this podcast,chances are that one of your
colleagues and friends probablywould as well.
Please do us a favor and letthem know about the podcast and,

(04:11):
if you have a little bit ofextra time, even just a few
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It would be greatly appreciated.
It would mean a lot to us andhelp get the word out to other
people that would really enjoyour content.
Thank you, hey y'all.
This is Josh.
You know we talked about somereally interesting stuff today.
I think one of the things we'regoing to do that's relevant.

(04:33):
There is a course we have on DrJournal Club called the EBM
Boot Camp.
That's really meant forclinicians to sort of help them
understand how to criticallyevaluate the literature, etc.
Cetera.
Some of the things that we'vebeen talking about today.
Go ahead and check out the shownotes link.
We're going to link to itdirectly.
I think it might be of interest.
Don't forget to follow us onsocial and interact with us on
social media at Dr Journal ClubDr Journal Club on Twitter,

(04:57):
we're on Facebook, we're onLinkedIn, et cetera, et cetera.
So please reach out to us.
We always love to talk to ourfans and our listeners.
If you have any specificquestions you'd like to ask us
about research, evidence, beinga clinician, et cetera, don't
hesitate to ask.
And then, of course, if youhave any topics that you'd like
us to cover on the pod, pleaselet us know as well.

Introducer (05:19):
Thank you for listening to the Doctor Journal
Club podcast, the show that goesunder the hood of
evidence-based integrativemedicine.
We review recent researcharticles, interview
evidence-based medicine thoughtleaders and discuss the
challenges and opportunities ofintegrating evidence-based and
integrative medicine.
Be sure to visit www.
drjournalclub.
com to learn more.