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In This Issue of JAMA
April 17, 2018


JAMA. 2018;319(15):1523-1525. doi:10.1001/jama.2017.12328

Studies of interventions for pelvic organ prolapse are limited by retrospective, noncomparative designs and poor follow-up. In a 5-year study of outcomes for 309 women randomized to receive treatments for pelvic organ prolapse or usual care, Jelovsek and colleagues found no differences in rates of surgical failure, anatomic success, or symptom scores.


Trials of low-density lipoprotein cholesterol (LDL-C)–lowering therapies have shown inconsistent reductions in mortality. A meta-analysis by Navarese and colleagues of 34 trials of LDL-C–lowering therapies with 270 288 participants found that patients were more likely to benefit if they had greater baseline levels of LDL-C. In an Editorial, Navar and Peterson note that patients at high risk of cardiovascular disease are likely to benefit from LDL-C–lowering therapy, irrespective of their baseline LDL-C levels.



Classes of glucose-lowering agents have not been compared head to head for clinical outcomes. In a network meta-analysis of 236 trials randomizing 176 310 participants, Zheng and colleagues found that in comparison with placebo or no treatment, sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists were associated with lower mortality than dipeptidyl peptidase 4 inhibitors.

Animated Summary Video

Clinical Review & Education

Osteoporotic fractures are common and debilitating. This US Preventive Services Task Force statement provides recommendations for vitamin D and calcium supplementation in women and men. In an Editorial, Bischoff-Ferrari and colleagues suggest that alternatives to nutrient supplementation, such as exercise, muscle strengthening, and balance training, can help to prevent fall injuries as well as chronic diseases of aging.

Editorial, Related Article, and JAMA Patient Page

Author Audio Interview and CME

In a review of 11 trials that enrolled 51 419 community-dwelling adults aged 50 years and older without vitamin D deficiency, osteoporosis, or prior fracture, Kahwati and colleagues found that vitamin D supplementation alone or with calcium was not associated with reduced fracture incidence, but vitamin D with calcium was associated with an increase in the incidence of kidney stones.

Editorial, Related Article and JAMA Patient Page

In this JAMA Clinical Guidelines Synopsis of a 2018 guideline developed by the Endocrine Society, the Androgen Excess and Polycystic Ovary Syndrome Society, and the European Society of Endocrinology, Mimoto and colleagues discuss the clinical management of premenopausal women with excessive male-pattern hair growth.