Eight RCTs were included in the review (n=12,658 participants).
Compared with placebo, cholecalciferol in combination with calcium supplementation was associated with a significant reduction in non-vertebral fractures (OR 0.77, 95% credibility interval 0.63 to 0.93; two RCTs) and hip fractures (OR 0.70, 95% credibility interval 0.53 to 0.90; three RCTs) and a non-significant reduction in non-vertebral-non-hip fractures (OR 0.84, 95% credibility interval 0.67 to 1.04; three RCTs).
Compared with calcium supplementation alone, cholecalciferol in combination with calcium supplementation was associated with a significant reduction in non-vertebral-non-hip fractures (OR 0.64, 95% credibility interval 0.38 to 0.99; two RCTs) and a non-significant reduction in non-vertebral fractures (OR 0.68, 95% credibility interval 0.43 to 1.01; two RCTs). There was no significant difference in rate of hip fractures between the two groups.
Sensitivity analyses did not materially alter the results. There was no evidence of significant publication bias. Results for the outcome of femoral neck bone mineral density were reported.