Ward 2010.

Methods	Multicentre, parallel, double‐blinded placebo‐controlled RCT.
Participants	139 randomised 4 ‐ 19 years (ALN 11.0 (3.6) years; placebo 11.1 (4.0) years 78 males 61 females Children and adolescents with a diagnosis of OI types III or IV or a diagnosis of OR type I associated with 1 or more of the following: chronic pain; more than 3 fractures (including vertebrae) per year with minimal trauma for the previous 2 years; or limb deformity requiring surgery.
Interventions	ALN or placebo for 24 months (< 40 kg) 5 mg daily (> 40 kg) 10 mg daily Placebo = 30 ALN = 109 Analysed: ALN = 83; placebo = 26
Outcomes	Fracture reduction Change in BMD as assessed by DEXA Change in biochemical markers of bone and mineral metabolism Growth Bone pain PEDI score Grip strength
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomized in a 3:1 ratio and stratified according to their weight at baseline.
Allocation concealment (selection bias)	Unclear risk	Not stated.
Blinding (performance bias and detection bias) All outcomes	Low risk	double blind. outcome assessors blind.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Total = 30, ALN = 26, Placebo = 4. Reasons given per group in figure 1 – consort diagram. Modified ITT.
Selective reporting (reporting bias)	Low risk	Outcomes reported.
Other bias	Low risk	None.