Gaps in evidence on treatment of male osteoporosis: a Research Agenda

Objective: To identify key research gaps regarding medication therapy to prevent osteoporotic fractures in men. Data sources: Articles from the peer-reviewed literature containing empirical studies of the use of medication therapy for fracture prevention in men, either in clinical trials or observational studies. Study selection and data extraction: We searched PubMed with search terms including “osteoporosis AND medication therapy management”. We read all articles to ensure that they were indeed empirical studies of our topic. For each included study, we searched for all articles in the bibliography, all articles that cited the article, and all related articles, using these functions in PubMed. Data synthesis: We have identified six research gaps that could inform the more rational, evidence-based treatment of male osteoporosis. Specifically, among men, we lack key information about: (1) whether treatment can prevent clinical fractures, (2) rates of side effects and complications of therapy, (3) the role of testosterone in treatment, (4) the comparative effectiveness of different therapeutic regimens, (5) role of drug holidays for those receiving bisphosphonates and sequential therapies, and (6) effectiveness of therapy for secondary prevention. Relevance to patient care and clinical practice: Addressing these six topics should be key goal for the next decade of research on male osteoporosis.