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Centre for Evidence-
Based Medicine

Steroid Induced - Osteoporosis Bisphosphonates Improves Bone Mineral Desity

Clinical Bottom Line

Bisphosphonates improve bone mineral density in patients with steroid induced osteoporosis.


Homik J, Cranney A, Shea B, et al. Bisphosphonates for steroid induced osteoporosis. CDSR 1999;issue 1.

Clinical Question

In a patient with steroid induced osteoporosis, does treatment with bisphosphonates reduce bone pain, fracture rate and improve bone mineral density?

Search Terms

"osteoporosis" and "steroids" in Cochrane Library

The Study

Systematic review of controlled trials that studied the effect of bisphosphonates on steroid induced osteoporosis. Bone mineral density was taken as the only outcome measure.

The Evidence

13 trials including 842 patients
Outcome ARR (weighted) NNT (95% CI)
Bone mineral density increase .043 23 (17 to 37)


The authors state that there is a relationship between BMD, and pain and fracture rates, but emphasise that the results do not permit us to draw conclusions about the efficacy of bisphosphonates in preventing fractures in steroid induced osteoporosis.

Appraised By

W Rosenberg, 1999

Expiry Date