Comparative efficacy and safety of odanacatib, abaloparatide, denosumab, teriparatide, and bisphosphonates for male osteoporosis: a systematic review and network meta-analysis

Background Evidence from randomized controlled trials (RCTs) on pharmacological management of primary osteoporosis in men is fragmented, making direct comparisons across drug classes difficult, and head-to-head evidence remains limited. We performed a network meta-analysis (NMA) to compare the relative efficacy and safety of commonly used anti-osteoporotic agents in men. Methods We systematically searched PubMed, Web of Science, and the Cochrane Library from inception to December 2025 for RCTs e