Table 5.
Anti-fracture efficacy of approved drug treatments for postmenopausal women, and men, with osteoporosis when given with calcium and vitamin D
| Intervention | Vertebral fracture | Non-vertebral fracture | Hip fracture | Evidence of superiority or inferiority for vertebral fracture prevention in postmenopausal women with very high fracture risk | Licenced for use in men |
|---|---|---|---|---|---|
| Romosozumab | Ib | IIb | IIb | Superior to alendronate (Ib) | No |
| Teriparatide | Ia | Ia | Ia | Superior to risedronate (Ib) | Yes |
| Alendronate | Ia | Ia | Ia | Inferior to romosozumab (Ib) | Yes |
| Ibandronate | Ib | Ib | NAE | NAE | No |
| Risedronate | Ia | Ia | Ia | Inferior to teriparatide (Ib) | Yes |
| Zoledronate | Ia | Ia | Ia | NAE | Yes |
| Calcitriol | IIa | NAE | NAE | NAE | Yes |
| Denosumab | Ia | Ia | Ia | NAE | Yes |
| HRT | Ia | Ia | Ia | NAE | No |
| Raloxifene | Ia | NAE | NAE | NAE | No |
| Strontium Ranelate | Ia | Ia | IIb | NAE | Yes |
Evidence levels shown (see Appendix 2). HRT hormone-replacement therapy; NAE no available evidence