{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:07:15Z","timestamp":1789222035719,"version":"build-2803163510"},"reference-count":50,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","clinicaltherapeutics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Therapeutics"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.clinthera.2026.08.006","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:13:02Z","timestamp":1787803982000},"page":"968-976","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacologic Adjuncts for Bone Stress Injuries in Athletes: A Narrative Review of Current Evidence and Clinical Practice"],"prefix":"10.1016","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5691-208X","authenticated-orcid":false,"given":"Richard","family":"Porter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Rees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.clinthera.2026.08.006_bib0001","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/bjsports-2022-106112","article-title":"Not all bone overuse injuries are stress fractures: it is time for updated terminology","volume":"57","author":"Warden","year":"2022","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0002","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/jisakos-2015-000010","article-title":"Stress fractures in football","volume":"1","author":"Dhillon","year":"2016","journal-title":"J ISAKOS"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0003","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1177\/2192568218823695","article-title":"The incidence of pars interarticularis defects in athletes","volume":"10","author":"Tawfik","year":"2020","journal-title":"Global Spine J"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0004","doi-asserted-by":"crossref","DOI":"10.1016\/j.bone.2021.116269","article-title":"Once daily calcium (1000 mg) and vitamin D (1000 IU) supplementation during military training prevents increases in biochemical markers of bone resorption but does not affect tibial microarchitecture in army recruits","volume":"155","author":"Gaffney-Stomberg","year":"2022","journal-title":"Bone"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0005","doi-asserted-by":"crossref","first-page":"223","DOI":"10.3390\/medicina57030223","article-title":"Vitamin D and stress fractures in sport: preventive and therapeutic measures\u2013a narrative review","volume":"57","author":"Knechtle","year":"2021","journal-title":"Medicina (Kaunas)"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0006","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.pmrj.2010.05.006","article-title":"Evaluating the relationship of calcium and vitamin D in the prevention of stress fracture injuries in the young athlete: a review of the literature","volume":"2","author":"Tenforde","year":"2010","journal-title":"PM R"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0007","first-page":"12","article-title":"The use of bisphosphonates in the management of pubic overload in an English Premier League footballer \u2013 a case report","volume":"50","author":"Johnson","year":"2026","journal-title":"Football Med Perform"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0008","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1016\/j.injury.2014.01.023","article-title":"Intravenous bisphosphonates and vitamin D in the treatment of bone marrow oedema in professional athletes","volume":"45","author":"Simon","year":"2014","journal-title":"Injury"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0009","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1097\/01.jsm.0000152716.06883.e0","article-title":"Treatment of stress fractures in athletes with intravenous pamidronate","volume":"15","author":"Stewart","year":"2005","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0010","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1097\/JSM.0b013e31820f8f62","article-title":"Treatment of lumbar pars interarticularis stress injuries in athletes with intravenous bisphosphonates: five case studies","volume":"21","author":"Chambers","year":"2011","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0011","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1002\/jor.21464","article-title":"Bisphosphonate treatment delays stress fracture remodeling in the rat ulna","volume":"29","author":"Kidd","year":"2011","journal-title":"J Orthop Res"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0012","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1136\/annrheumdis-2011-200970","article-title":"Zoledronic acid reduces knee pain and bone marrow lesions over 1 year: a randomised controlled trial","volume":"71","author":"Laslett","year":"2012","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0013","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00167-009-0742-z","article-title":"Do not use bisphosphonates without scientific evidence, neither in treatment nor prophylactic, in the treatment of stress fractures","volume":"17","author":"Ekenman","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0014","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1007\/s00167-008-0673-0","article-title":"Use of bisphosphonates for the treatment of stress fractures in athletes","volume":"17","author":"Shima","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0015","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4137\/CMED.S9663","article-title":"Role of teriparatide in accelerating metatarsal stress fracture healing: a case series and review of literature","volume":"5","author":"Raghavan","year":"2012","journal-title":"Clin Med Insights Endocrinol Diabetes"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0016","doi-asserted-by":"crossref","first-page":"e163","DOI":"10.1097\/JSM.0000000000000739","article-title":"Delayed-union of acetabular stress fracture in female gymnast: use of teriparatide to augment healing","volume":"30","author":"Gende","year":"2020","journal-title":"Clin J Sport Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0017","first-page":"1398","article-title":"Treatment of tibial stress fracture in elite college athlete using teriparatide (Forteo)","volume":"10","author":"Laird","year":"2025","journal-title":"J Orthop Res Ther"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0018","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s12178-017-9392-9","article-title":"Tarsal navicular stress fractures","volume":"10","author":"Shakked","year":"2017","journal-title":"Curr Rev Musculoskelet Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0019","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.3899\/jrheum.111458","article-title":"Enhanced healing of sacral and pubic insufficiency fractures by teriparatide","volume":"39","author":"Wu","year":"2012","journal-title":"J Rheumatol"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0020","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1186\/s13063-021-05556-3","article-title":"Teriparatide and stress fracture healing in young adults (RETURN \u2013 research on efficacy of teriparatide use in the return of recruits to normal duty): study protocol for a randomised controlled trial","volume":"22","author":"Carswell","year":"2021","journal-title":"Trials"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0021","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.wneu.2023.07.056","article-title":"Effectiveness of teriparatide for spine fusion in osteoporotic patient: a systematic review and meta-analysis of comparative studies","volume":"179","author":"Pan","year":"2023","journal-title":"World Neurosurg"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0022","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1210\/jc.2014-1041","article-title":"Teriparatide increases strength of the peripheral skeleton in premenopausal women with idiopathic osteoporosis: a pilot HR-pQCT study","volume":"99","author":"Nishiyama","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0023","article-title":"Efficacy and safety of teriparatide in improving fracture healing and callus formation: a systematic review","volume":"15","author":"Puvvada","year":"2023","journal-title":"Cureus"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0024","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1001\/jama.2016.11136","article-title":"Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis: a randomized clinical trial","volume":"316","author":"Miller","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0025","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s13018-023-03595-x","article-title":"Is abaloparatide more efficacious on increasing bone mineral density than teriparatide for women with postmenopausal osteoporosis? An updated meta-analysis","volume":"18","author":"Hong","year":"2023","journal-title":"J Orthop Surg Res"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0026","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1056\/NEJMoa1708322","article-title":"Romosozumab or alendronate for fracture prevention in women with osteoporosis","volume":"377","author":"Saag","year":"2017","journal-title":"N Engl J Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0027","article-title":"Successful treatment of humeral shaft nonunion with romosozumab: a case report","volume":"37","author":"Lee","year":"2022","journal-title":"Trauma Case Rep"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0028","article-title":"Managing delayed union of fragility fractures of the pelvis successfully using romosozumab: a case report","volume":"57","author":"Wada","year":"2025","journal-title":"Trauma Case Rep"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0029","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1177\/1089313X251315812","article-title":"Pilot study of bone turnover biomarkers, diet, and exercise in elite female ballet dancers","volume":"29","author":"Bladt","year":"2025","journal-title":"J Dance Med Sci"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0030","first-page":"230","article-title":"Prescribing practices and interventions in elite football: patterns and perspectives","volume":"61","author":"Porter","year":"2026","journal-title":"Apunts Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0031","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1136\/bjsports-2024-108616","article-title":"International Delphi consensus on bone stress injuries in athletes","volume":"59","author":"Hoenig","year":"2025","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0032","doi-asserted-by":"crossref","first-page":"S293","DOI":"10.1016\/j.jacr.2017.02.035","article-title":"ACR Appropriateness Criteria\u00ae stress (fatigue\/insufficiency) fracture, including sacrum, excluding other vertebrae","volume":"14","author":"Bencardino","year":"2017","journal-title":"J Am Coll Radiol"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0033","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1080\/17453674.2016.1205172","article-title":"Inter-trabecular bone formation: a specific mechanism for healing of cancellous bone","volume":"87","author":"Sandberg","year":"2016","journal-title":"Acta Orthop"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0034","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1177\/0363546513490645","article-title":"Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes","volume":"41","author":"Nattiv","year":"2013","journal-title":"Am J Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0035","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s00256-023-04437-x","article-title":"T1-VIBE and STIR MRI of lumbar pars interarticularis injuries in elite athletes: fracture characterisation and potential prognostic indicators","volume":"53","author":"Watura","year":"2024","journal-title":"Skeletal Radiol"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0036","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.bone.2019.07.030","article-title":"Lumbar bone mineral asymmetry in elite cricket fast bowlers","volume":"127","author":"Alway","year":"2019","journal-title":"Bone"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0037","doi-asserted-by":"crossref","first-page":"878","DOI":"10.2214\/AJR.11.6826","article-title":"Validation of MRI classification system for tibial stress injuries","volume":"198","author":"Kijowski","year":"2012","journal-title":"Am J Roentgenol"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0038","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00007632-200201150-00012","article-title":"Stress reactions of the lumbar pars interarticularis: the development of a new MRI classification system","volume":"27","author":"Hollenberg","year":"2002","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0039","doi-asserted-by":"crossref","first-page":"2847","DOI":"10.1016\/j.acra.2024.12.065","article-title":"Overview of radiological classification systems for pars interarticularis stress Injuries-and proposal of the BROPI classification","volume":"32","author":"Henderson","year":"2025","journal-title":"Acad Radiol"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0040","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1136\/bjsports-2023-106994","article-title":"2023 International Olympic Committee\u2019s (IOC) consensus statement on relative energy deficiency in sport (REDs)","volume":"57","author":"Mountjoy","year":"2023","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0041","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/1759720X13477714","article-title":"Bisphosphonate drug holiday: who, when and how long","volume":"5","author":"Diab","year":"2013","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0042","unstructured":"Oliveras M, Diana D, Mu\u00f1oz N. Use of teriparatide to accelerate the healing of lower extremity stress fractures in high-level and high-performance athletes\u2013a phase IV\/II multicenter randomized clinical trial. 2015."},{"key":"10.1016\/j.clinthera.2026.08.006_bib0043","article-title":"A commentary of factors related to player availability and its influence on performance in elite team sports","volume":"4","author":"Calleja-Gonz\u00e1lez","year":"2022","journal-title":"Front Sports Act Living"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0044","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s40279-022-01799-5","article-title":"The effects of fixture congestion on injury in professional male soccer: a systematic review","volume":"53","author":"Page","year":"2022","journal-title":"Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0045","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1136\/bjsports-2012-092096","article-title":"Fifth metatarsal fractures among male professional footballers: a potential career-ending disease","volume":"47","author":"Ekstrand","year":"2013","journal-title":"Br J Sports Med"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0046","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00774-024-01536-0","article-title":"Clinical effects of teriparatide, abaloparatide, and romosozumab in postmenopausal osteoporosis","volume":"43","author":"Ebina","year":"2023","journal-title":"J Bone Miner Metab"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0047","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00198-020-05806-1","article-title":"Differential effects of abaloparatide and teriparatide on hip cortical volumetric BMD by DXA-based 3D modeling","volume":"32","author":"Winzenrieth","year":"2021","journal-title":"Osteoporos Int"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0048","first-page":"70","article-title":"Bone mineral density response rates are greater in patients treated with abaloparatide compared with those treated with placebo or teriparatide: results from the ACTIVE phase 3 trial","volume":"112","author":"Cosman","year":"2018","journal-title":"Bone"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0049","doi-asserted-by":"crossref","first-page":"3384","DOI":"10.1210\/clinem\/dgaa450","article-title":"Cardiovascular safety of abaloparatide in postmenopausal women with osteoporosis: analysis from the ACTIVE phase 3 trial","volume":"105","author":"Cosman","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.clinthera.2026.08.006_bib0050","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1089\/mab.2019.0049","article-title":"Safety of romosozumab in osteoporotic men and postmenopausal women: a meta-analysis and systematic review","volume":"39","author":"Mariscal","year":"2020","journal-title":"Monoclon Antib Immunodiagn Immunother"}],"container-title":["Clinical Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0149291826003073?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0149291826003073?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:32:05Z","timestamp":1789219925000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0149291826003073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":50,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S0149291826003073"],"URL":"https:\/\/doi.org\/10.1016\/j.clinthera.2026.08.006","relation":{},"ISSN":["0149-2918"],"issn-type":[{"value":"0149-2918","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Pharmacologic Adjuncts for Bone Stress Injuries in Athletes: A Narrative Review of Current Evidence and Clinical Practice","name":"articletitle","label":"Article Title"},{"value":"Clinical Therapeutics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.clinthera.2026.08.006","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc.","name":"copyright","label":"Copyright"}]}}