Comparison 1. Bisphosphonates versus placebo.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Number of participants whose bone pain disappeared completely	2	205	Risk Ratio (M‐H, Random, 95% CI)	3.42 [1.31, 8.90]
2 Number of participants with change in bone pain	7	481	Risk Ratio (M‐H, Random, 95% CI)	1.97 [1.29, 3.01]
2.1 Etidronate vs. placebo	3	124	Risk Ratio (M‐H, Random, 95% CI)	1.75 [0.79, 3.87]
2.2 Tiludronate vs. placebo	3	344	Risk Ratio (M‐H, Random, 95% CI)	1.98 [1.27, 3.08]
2.3 Alendronate vs. placebo	1	13	Risk Ratio (M‐H, Random, 95% CI)	10.00 [0.69, 144.38]
3 Number of participants experiencing radiologically‐confirmed clinical fractures	4	356	Odds Ratio (M‐H, Random, 95% CI)	0.89 [0.18, 4.51]
3.1 Etidronate vs. placebo	2	95	Odds Ratio (M‐H, Random, 95% CI)	0.90 [0.09, 9.06]
3.2 Tiludronate vs. placebo	2	261	Odds Ratio (M‐H, Random, 95% CI)	0.88 [0.09, 8.64]
4 Number of participants who experienced adverse events related to use of bisphosphonates	6	678	Risk Difference (M‐H, Random, 95% CI)	0.11 [‐0.00, 0.22]
4.1 Etidronate vs. placebo	1	47	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.21, 0.25]
4.2 Zoledronate vs. placebo	1	176	Risk Difference (M‐H, Random, 95% CI)	0.27 [0.12, 0.42]
4.3 Tiludronate vs. placebo	3	400	Risk Difference (M‐H, Random, 95% CI)	0.07 [‐0.08, 0.22]
4.4 Alendronate vs. placebo	1	55	Risk Difference (M‐H, Random, 95% CI)	0.12 [‐0.11, 0.34]
5 Number of participants who withdrew due to adverse events	6	517	Odds Ratio (M‐H, Random, 95% CI)	1.01 [0.38, 2.69]
5.1 Etidronate vs. placebo	1	47	Odds Ratio (M‐H, Random, 95% CI)	0.0 [0.0, 0.0]
5.2 Tiludronate vs. placebo	3	400	Odds Ratio (M‐H, Random, 95% CI)	0.96 [0.34, 2.67]
5.3 Alendronate vs. placebo	2	70	Odds Ratio (M‐H, Random, 95% CI)	1.74 [0.06, 50.43]
6 Mean percentage change from baseline in serum total alkaline phosphatase level	8	592	Mean Difference (IV, Random, 95% CI)	‐50.09 [‐67.72, ‐32.46]
6.1 Etidronate vs. placebo	3	122	Mean Difference (IV, Random, 95% CI)	‐55.85 [‐66.50, ‐45.20]
6.2 Zoledronate vs. placebo	1	176	Mean Difference (IV, Random, 95% CI)	‐22.26 [‐27.99, ‐16.53]
6.3 Tiludronate vs. placebo	2	256	Mean Difference (IV, Random, 95% CI)	‐58.0 [‐64.25, ‐51.75]
6.4 Alendronate vs. placebo	1	15	Mean Difference (IV, Random, 95% CI)	‐39.9 [‐51.28, ‐28.52]
6.5 Ibandronate vs. placebo	1	23	Mean Difference (IV, Random, 95% CI)	‐96.1 [‐147.01, ‐45.19]
7 Number of participants who achieved normalised alkaline phosphatase level	8	580	Risk Ratio (M‐H, Random, 95% CI)	9.96 [3.74, 26.58]
7.1 Etidronate vs. placebo	3	121	Risk Ratio (M‐H, Random, 95% CI)	4.51 [0.90, 22.55]
7.2 Tiludronate vs. placebo	3	381	Risk Ratio (M‐H, Random, 95% CI)	13.79 [2.77, 68.61]
7.3 Alendronate vs. placebo	1	55	Risk Ratio (M‐H, Random, 95% CI)	27.96 [1.74, 448.28]
7.4 Ibandronate vs. placebo	1	23	Risk Ratio (M‐H, Random, 95% CI)	14.00 [0.92, 212.92]