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The following is a summary of “Efficacy and safety of abaloparatide, denosumab, teriparatide, oral bisphosphonates, and intravenous bisphosphonates in the treatment of male osteoporosis: a systematic review and Bayesian network meta-analysis,” published in the April 2025 issue of Frontiers in Endocrinology by Chen et al. 

Various medications, including abaloparatide (ABA), denosumab (DEN), teriparatide (TER), and oral bisphosphonates (OBP), were available for treating male osteoporosis, but a lack of systematic comparative studies hindered treatment selection, particularly for specific male osteoporosis populations.  

Researchers conducted a retrospective study to compare the efficacy and safety of ABA, DEN, TER, OBP, and intravenous bisphosphonates (IBP) in treating male osteoporosis through a network meta-analysis.  

They executed a systematic review and network meta-analysis (NMA) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and Cochrane standards. Pairwise meta-analysis was performed using Stata 18.0 software to evaluate effect sizes and consistency. The NMA was carried out with R version 4.3.1 using the gemtc and BUGSnet packages for multi-treatment comparisons. Statistical analyses were completed with Review Manager software (version 5.4) for meta-analysis, forest plot creation, and bias risk assessment.  

The results showed that TER was most effective in reducing all adverse events (AEs) but showed lower efficacy in improving total hip bone mineral density (BMD). The OBP reduced severe AEs more effectively but had slightly lower efficacy in femoral neck BMD improvement. Clinicians should consider patient-specific needs, treatment goals, and drug safety, particularly for long-term use.  

Investigators concluded that while ABA and TER were most effective for improving BMD in the lumbar spine and femoral neck, and OBP for the total hip, TER demonstrated the best safety profile overall, and OBP had fewer severe AEs, necessitating individualized treatment decisions balancing efficacy and safety.   

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1558560/full