Table 5.

Quality assessment of studies (Newcastle-Ottawa Scale).

Reference	Selection				Comparability	Outcome
	Was the exposed cohort representative?	Selection of the non-exposed cohort	Ascertainment of exposure	Demonstration that outcome of interest was not present at start of study	Comparability of cohorts on the basis of the design or analysis	Assessment of outcome	Was follow-up long enough for outcomes to occur	Adequacy of follow up of cohorts	Overall quality assessment NOS score (0–9)
J.P Bodem et al., 2015 [25]	∗ Truly representative of typical patients being treated with high-dose ARs in the community.	∗ Drawn from the same community as the exposed cohort	∗ Secure record	∗ Yes	∗ Study controls for ongoing vs. completed/paused therapy. ∗Study controls for additional factors	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	9
G. Saia et al., 2010 [23]	∗ Truly representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	∗ Yes	∗ Study controls for additional factors	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Ferlito et al., 2011 [24]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	∗ Yes	∗ Study controls for type of bisphosphonates	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Dimitrakopoulos et al., 2006 [36]	Selected group of users.	No description	∗ Secure record	No	-	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	3
Wilde et al., 2011 [27]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for patients' generel health status. ∗Study controls for additional factors	∗ Independent assessment	∗ Yes	∗ 37.5% lost to follow-up, description provided of those lost	4
Jabbour et al., 2012 [29]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	-	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	5
Voss et al., 2012 [30]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for duration of bisphosphonates. ∗Study controls for additional factors	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Wutzl et al., 2012 [26]	∗ Truly representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	∗ Yes	∗ Study controls for the effect of continuing therapy with bisphosphonates. ∗Study controls for additional factors.	∗ Independent assessment	∗ Yes	∗ 15% lost to follow-up, but unlikely to produce bias	8
Kim et al., 2014 [31]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for drug holiday. ∗Study controls for additional factors.	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Lopes et al., 2015 [32]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	-	∗ Independent assessment	∗ Yes	∗ 61% lost to follow up. Descriptions provided for the subjects who could not be followed up.	5
Bodem et al., 2016 [33]	∗ Truly representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for drug holidays. ∗Study controls for additional factors.	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Hoefert et al., 2017 [34]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for the duration of therapy. ∗Study controls for additional factors.	∗ Independent assessment	∗ Yes	∗ Complete follow up - all subjects accounted for	7
Aljohani et al., 2018 [35]	∗ Truly representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for denosumab dose. ∗Study controls for additional factors.	∗ Independent assessment	∗ Yes	17% lost to follow-up. No descriptions of the subjects who could not be followed up.	6
Jung et al., 2018 [28]	∗ Somewhat representative of typical patients being treated with high-dose ARs in the community.	No description	∗ Secure record	No	∗ Study controls for drug holidays. ∗Study controls for additional factors.	∗ Independent assessment	No statement	No statement	4

AR: Antiresorptive.

^∗One star is awarded for each item, with a maximum of two stars being awarded for comparability; -: Not described in the article.