Questioning the Accuracy of a Recent Review of Osteoporosis Medications
Authors: Catherine MacLean
Journal: Annals of Internal Medicine (2009)

Letters17 March 2009Questioning the Accuracy of a Recent Review of Osteoporosis MedicationsCatherine MacLean, MD, PhD and Marika Suttorp, MSCatherine MacLean, MD, PhDFrom RAND Corporation, Santa Monica, CA 90407.Search for more papers by this author and Marika Suttorp, MSFrom RAND Corporation, Santa Monica, CA 90407.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-6-200903170-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The concerns of Ms. Kuhl and colleagues about our article and the report from which it was derived (1) can be grouped into 3 categories: questions about how meta-analysis could find a statistically significant association between a drug and an outcome when none of the individual studies reported a statistically significant association, questions about what outcomes and studies should have been included in the review, and errors of fact.First, the fact that a meta-analytic pooled result shows a statistically significant association when none of the individual studies themselves did so should not be surprising: Pooling studies to ...References1. MacLean C, Alexander A, Carter J, Chen S, Desai SB, Grossman J, et al. Comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Comparative Effectiveness Review No. 12. (Prepared by the Southern California/RAND Evidence-based Practice Center under contract 290-02-0003). Rockville, MD: Agency for Healthcare Research and Quality; 2007. Accessed at effectivehealthcare.ahrq.gov/repFiles/LowBoneDensityFinal.pdf on 14 January 2009. Google Scholar2. McClung MR, Wasnich RD, Recker R, Cauley JA, Chesnut CH, Ensrud KE, et al; Oral Ibandronate Study Group. Oral daily ibandronate prevents bone loss in early postmenopausal women without osteoporosis. J Bone Miner Res. 2004;19:11-8. [PMID: 14753731] CrossrefMedlineGoogle Scholar3. Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, et al; Oral Ibandronate Osteoporosis Vertebral Fracture Trial in North America and Europe (BONE). Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004;19:1241-9. [PMID: 15231010] CrossrefMedlineGoogle Scholar4. Kaufman JM, Orwoll E, Goemaere S, San Martin J, Hossain A, Dalsky GP, et al. Teriparatide effects on vertebral fractures and bone mineral density in men with osteoporosis: treatment and discontinuation of therapy. Osteoporos Int. 2005;16:510-6. [PMID: 15322742] CrossrefMedlineGoogle Scholar5. Orwoll ES, Scheele WH, Paul S, Adami S, Syversen U, Diez-Perez A, et al. The effect of teriparatide [human parathyroid hormone (1-34)] therapy on bone density in men with osteoporosis. J Bone Miner Res. 2003;18:9-17. [PMID: 12510800] CrossrefMedlineGoogle Scholar6. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344:1434-41. [PMID: 11346808] CrossrefMedlineGoogle Scholar7. Grady D, Ettinger B, Moscarelli E, Plouffe L, Sarkar S, Ciaccia A, et al; Multiple Outcomes of Raloxifene Evaluation Investigators. Safety and adverse effects associated with raloxifene: multiple outcomes of raloxifene evaluation. Obstet Gynecol. 2004;104:837-44. [PMID: 15458908] CrossrefMedlineGoogle Scholar8. Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282:637-45. [PMID: 10517716] CrossrefMedlineGoogle Scholar9. Barrett-Connor E, Mosca L, Collins P, Geiger MJ, Grady D, Kornitzer M, et al; Raloxifene Use for The Heart (RUTH) Trial Investigators. Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006;355:125-37. [PMID: 16837676] CrossrefMedlineGoogle Scholar10. Vogel VG, Costantino JP, Wickerham DL, Cronin WM, Cecchini RS, Atkins JN, et al; National Surgical Adjuvant Breast and Bowel Project (NSABP). Effects of tamoxifen vs raloxifene on the risk of developing invasive breast cancer and other disease outcomes: the NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 trial. JAMA. 2006;295:2727-41. [PMID: 16754727] CrossrefMedlineGoogle Scholar11. Reid DM, Hughes RA, Laan RF, Sacco-Gibson , Wenderoth DH, Adami S, et al. Efficacy and safety of daily risedronate in the treatment of corticosteroid-induced osteoporosis in men and women: a randomized trial. European Corticosteroid-Induced Osteoporosis Treatment Study. J Bone Miner Res. 2000;15:1006-13. [PMID: 10841169] CrossrefMedlineGoogle Scholar12. Fisher B, Costantino JP, Wickerham DL, Redmond CK, Kavanah M, Cronin WM, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90:1371-88. [PMID: 9747868] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From RAND Corporation, Santa Monica, CA 90407.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Comparative Effectiveness of Treatments to Prevent Fractures in Men and Women with Low Bone Density or Osteoporosis Catherine MacLean , Sydne Newberry , Margaret Maglione , Maureen McMahon , Veena Ranganath , Marika Suttorp , Walter Mojica , Martha Timmer , Alicia Alexander , Melissa McNamara , Sheetal B. Desai , Annie Zhou , Susan Chen , Jason Carter , Carlo Tringale , Di Valentine , Breanne Johnsen , and Jennifer Grossman Questioning the Accuracy of a Recent Review of Osteoporosis Medications Laura N. Kuhl , Bruce Ettinger , Clifford J. Rosen , and Nananda F. Col Metrics 17 March 2009Volume 150, Issue 6Page: 424-425KeywordsAdverse eventsBreast cancerCancer treatmentGynecologic cancersHemorrhageMyocardial infarctionOsteoporosisRisk managementUlcers ePublished: 17 March 2009 Issue Published: 17 March 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...