ACTIVE 2016.

Study characteristics
Methods	Study design: parallel RCT Time frame: March 2011 to October 2014 Duration of study follow‐up: 19 months (18 months of treatment plus 1 month of follow‐up)
Participants	Country: multinational (Argentina, Brazil, China, Czech Republic, Denmark, Estonia, Lithuania, Poland, Romania, USA) Setting: multicentre (28 sites) Inclusion criteria: postmenopausal women; CKD stage 3; osteoporosis or past fracture and osteopenia; normal bone markers Number: total (527); treatment group (168); control group 1 (167); control group 2 (192) Mean age ± SD: 74.0 ± 5.5 years Sex: women only CKD stage: CKD stages 3‐4 (eGFR < 60 mL/min) BMI: not reported Diabetes: not reported Current smoker: not reported Exclusion criteria: bone disorder other than postmenopausal status; use of corticosteroids; prior treatment with other anti‐osteoporotic drugs
Interventions	Treatment group Abaloparatide: 80 μg/day self‐administered by SC injection Control group 1 Placebo Control group 2 (active comparator) Teriparatide: 20 μg/day self‐administered by SC injection Co‐interventions Calcium: 500 to 1000 mg Vitamin D: 400 to 800 IU Actual use of calcium or vitamin D: not reported
Outcomes	Primary outcome New vertebral fractures Secondary outcomes Nonvertebral fractures Moderate and severe vertebral fractures Percentage change in the BMD of the lumbar spine, total hip, and femoral neck from baseline compared with teriparatide Change in bone turnover biomarkers (s‐PINP, s‐CTX) Adverse events
Notes	Funding source: The study was funded by Radius Health Further information was requested, but no response was received
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Participants were randomly assigned to each treatment groups by means of a central, interactive, automated telephone system
Allocation concealment (selection bias)	Low risk	Allocation was concealed because participants were assigned to each group using a central, interactive, automated telephone system
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Active comparator (teriparatide) could not be repackaged and blinded. However, the comparison between abaloparatide and placebo, which was main purpose of this study, could be blinded
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Efficacy and safety outcomes were assessed by blinded and independent assessors
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Missing outcome data were balanced in numbers across intervention groups; however, the reasons for missing data were not stated
Selective reporting (reporting bias)	High risk	All predefined efficacy and safety outcomes were reported, however BMD was reported incompletely so that these data could not be entered in a meta‐analysis (no control group data)
Other bias	High risk	The study was funded by Radius Health