Comparison 1. Bisphosphonates versus control (without lung transplantation).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Vertebral fractures	4		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
1.1 12 months	3	107	Odds Ratio (M‐H, Fixed, 95% CI)	0.19 [0.01, 4.21]
1.2 24 months	2	44	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Non‐vertebral fractures	3		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
2.1 12 months	2	60	Odds Ratio (M‐H, Fixed, 95% CI)	2.11 [0.18, 25.35]
2.2 24 months	2	44	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Total Fractures	4		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
3.1 12 months	3	107	Odds Ratio (M‐H, Fixed, 95% CI)	0.72 [0.13, 3.80]
3.2 24 months	2	44	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Per cent change in BMD, lumbar spine, DXA (Time‐points)	6		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
4.1 6 months	4	101	Mean Difference (IV, Fixed, 95% CI)	4.61 [3.90, 5.32]
4.2 12 months	4	136	Mean Difference (IV, Fixed, 95% CI)	6.10 [5.10, 7.10]
4.3 24 months	2	43	Mean Difference (IV, Fixed, 95% CI)	5.49 [4.38, 6.60]
5 Per cent change in BMD, lumbar spine, DXA (End of study)	6		Mean Difference (IV, Fixed, 95% CI)	Subtotals only
5.1 End of study	6	164	Mean Difference (IV, Fixed, 95% CI)	5.67 [4.81, 6.53]
6 Per cent change in BMD, total hip / femur, DXA (Time‐points)	5		Mean Difference (IV, Random, 95% CI)	Subtotals only
6.1 6 months	3	96	Mean Difference (IV, Random, 95% CI)	3.35 [1.63, 5.07]
6.2 12 months	4	135	Mean Difference (IV, Random, 95% CI)	4.35 [2.99, 5.70]
6.3 24 months	2	42	Mean Difference (IV, Random, 95% CI)	6.05 [3.74, 8.36]
7 Per cent change in BMD, total hip/femur, DXA (End of study)	5		Mean Difference (IV, Random, 95% CI)	Subtotals only
7.1 End of study	5	158	Mean Difference (IV, Random, 95% CI)	4.29 [2.45, 6.13]
8 Per cent change in BMD, distal radius, SXA (Time‐points)	2		Mean Difference (IV, Random, 95% CI)	Subtotals only
8.1 6 months	2	48	Mean Difference (IV, Random, 95% CI)	‐0.49 [‐2.42, 1.45]
8.2 12 months	1	18	Mean Difference (IV, Random, 95% CI)	0.32 [‐0.30, 0.94]
8.3 24 months	1	14	Mean Difference (IV, Random, 95% CI)	1.5 [0.41, 2.59]
9 Per cent change in BMD, distal radius, SXA (End of study)	2		Mean Difference (IV, Random, 95% CI)	Subtotals only
9.1 End of study	2	42	Mean Difference (IV, Random, 95% CI)	0.01 [‐3.12, 3.14]
10 Per cent change in BMD, ultra distal radius, SXA	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
10.1 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Quality of Life	1	94	Mean Difference (IV, Fixed, 95% CI)	‐0.11 [‐3.35, 3.12]
11.1 Physical component	1	47	Mean Difference (IV, Fixed, 95% CI)	2.51 [‐1.38, 6.40]
11.2 Mental component	1	47	Mean Difference (IV, Fixed, 95% CI)	‐5.93 [‐11.73, ‐0.13]
12 Bone pain	6		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
12.1 Oral bisphosphonates	3	131	Odds Ratio (M‐H, Fixed, 95% CI)	43.59 [2.27, 837.56]
12.2 Intravenous bisphosphonates	3	60	Odds Ratio (M‐H, Fixed, 95% CI)	14.17 [3.64, 55.17]
12.3 All routes of bisphosphonate administration	6	191	Odds Ratio (M‐H, Fixed, 95% CI)	18.52 [5.39, 63.57]
13 Fever	4		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
13.1 Oral bisphosphonates	1	48	Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
13.2 Intravenous bisphosphonates	3	55	Odds Ratio (M‐H, Fixed, 95% CI)	12.64 [2.31, 69.11]
13.3 All routes of bisphosphonate administration	4	103	Odds Ratio (M‐H, Fixed, 95% CI)	12.64 [2.31, 69.11]
14 Withdrawals, due to adverse events	5		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
14.1 6 months	2	53	Odds Ratio (M‐H, Fixed, 95% CI)	3.95 [0.14, 108.09]
14.2 12 months	4	162	Odds Ratio (M‐H, Fixed, 95% CI)	4.07 [1.11, 14.90]
14.3 24 months	2	58	Odds Ratio (M‐H, Fixed, 95% CI)	16.34 [1.98, 134.89]
15 Withdrawals, total	5		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
15.1 6 months	2	53	Odds Ratio (M‐H, Fixed, 95% CI)	2.83 [0.39, 20.73]
15.2 12 months	3	126	Odds Ratio (M‐H, Fixed, 95% CI)	0.96 [0.38, 2.46]
15.3 24 months	2	58	Odds Ratio (M‐H, Fixed, 95% CI)	0.95 [0.34, 2.69]
16 Survival	6		Odds Ratio (M‐H, Fixed, 95% CI)	Subtotals only
16.1 6 months	2	36	Odds Ratio (M‐H, Fixed, 95% CI)	0.93 [0.05, 16.39]
16.2 12 months	3	140	Odds Ratio (M‐H, Fixed, 95% CI)	2.98 [0.30, 29.84]
16.3 24 months	2	58	Odds Ratio (M‐H, Fixed, 95% CI)	4.27 [0.43, 42.63]