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Review
. 2019 Sep 9:22:7-13.
doi: 10.1016/j.jot.2019.08.004. eCollection 2020 May.

The efficacy and safety of denosumab in postmenopausal women with osteoporosis previously treated with bisphosphonates: A review

Yilin Zhu  1 , Zhonglian Huang  1 , Yan Wang  2 , Weicai Xu  1 , Hongjiang Chen  1 , Jiankun Xu  1   3 , Shaowei Luo  1 , Yuantao Zhang  1 , Di Zhao  1 , Jun Hu  1
Affiliations
Review

The efficacy and safety of denosumab in postmenopausal women with osteoporosis previously treated with bisphosphonates: A review

Yilin Zhu et al. J Orthop Translat. .

Abstract

Objective: The objective of this study was to assess the efficacy and safety of denosumab therapy in osteoporotic postmenopausal women who were previously treated with bisphosphonates.

Methods: Meta-analyses of four available randomised controlled trials that compared osteoporotic patients who switched to denosumab from bisphosphonates (n ​= ​1416) and those who continued bisphosphonates therapy (n ​= ​1411) were included.

Results: The increase in bone mineral density (BMD) of both the spine and hip was significantly higher in patients who shifted to denosumab than in those who continued bisphosphonates. Despite the incidence of adverse events (AEs) and fractures being comparable, treatment withdrawal owing to AEs was significantly less frequent in the denosumab group.

Conclusion: The outcomes and treatment compliance were improved in postmenopausal osteoporotic women who shifted to denosumab from bisphosphonates.

The translational potential of this article: The replacement of bisphosphonates with denosumab may lead to better therapeutic efficacy and fewer adherence barriers ​than those with continued usage of bisphosphonates, which in the future may guide the choice of drug therapy in clinics.

Keywords: Bisphosphonate; Denosumab; Meta-analysis; Osteoporosis; Postmenopausal osteoporosis; Randomised controlled trial.

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Figures

Figure 1
Figure 1
(A) Schematic illustration of literature search and study selection criteria; (B) quality analysis. RCTs = randomised controlled trials.
Figure 2
Figure 2
(A) Meta-analysis of the percent increase in total hip density; (B) the percent increase in vertebral density; (C) comparison of the incidence of all adverse reactions; (D) withdrawal from the study caused by adverse reactions; (E) pain in the musculoskeletal system; (F) joint pain; (G) upper respiratory tract infection. CI = confidence interval; SD = standard deviation.
Figure 3
Figure 3
Comparison of the (A) infection rates; (B) eczema; (C) severe adverse reactions; (D) severe infection; (E) malignant tumours; and (F) fracture. CI = confidence interval.
See this image and copyright information in PMC

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