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Meta-Analysis
. 2024 Aug 29;19(1):521.
doi: 10.1186/s13018-024-05008-z.

Efficacy and safety of odanacatib in the treatment of postmenopausal women with osteoporosis: a meta-analysis

Jiaxuan Li #  1   2 , Qi Qiu #  1   2 , Shide Jiang  3 , Jianfeng Sun  1   4 , Volotovski Pavel  5 , Yusheng Li  6   7
Affiliations
Meta-Analysis

Efficacy and safety of odanacatib in the treatment of postmenopausal women with osteoporosis: a meta-analysis

Jiaxuan Li et al. J Orthop Surg Res. .

Abstract

Background: Osteoporosis, a systemic skeletal disease, seriously affects the quality of life in postmenopausal women. As one type of cathepsin K (CatK) inhibitor, odanacatib (ODN) is a fresh medication for osteoporosis. Considering the potential of ODN, we further examined the effect and safety of ODN for postmenopausal osteoporosis (PMOP) with a meta-analysis.

Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched for eligible studies from inception to December 29th, 2023. After that, we conducted a comprehensive meta-analysis following PRISMA guidelines. Risk of bias was meticulously investigated with the Cochrane Collaboration's tool. Efficacy was assessed with bone mineral density (BMD) at different sites (lumbar spine, trochanter, radius, femoral neck) and biomarkers of bone turnover (P1NP, uNTx/Cr, s-CTx, BSAP). Safety was evaluated by analyzing total, serious, other, and skin adverse events (AEs).

Results: Four random clinical trials (RCTs) were involved in our research. All trials were rated as having high quality and met the eligibility criteria. In the current research, ODN was found to elevate BMD at lumbar spine, femoral neck, total hip, trochanter and forearm, while it decreased the levels of serum C-telopeptides of type I collagen (s-CTx) as well as urinary N-telopeptide/creatinine ratio (uNTx/Cr). No significant differences were observed in AEs between the ODN group and the control group.

Conclusions: ODN is a promising alternative for the treatment of PMOP on account of its excellent efficacy and credible safety. Unclear links between ODN and cardiovascular AEs require further research to clarify.

Keywords: Efficacy; Odanacatib; Postmenopausal osteoporosis; Safety.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the study collection process
Fig. 2
Fig. 2
Risk of bias assessment. (A) Risk of bias for each item was assessed as a percentage for all included literature. (B) Risk of bias for each item
Fig. 3
Fig. 3
Forest plot showing the effect of odanacatib on LS BMD. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 4
Fig. 4
Forest plot showing the effect of odanacatib on FN BMD. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 5
Fig. 5
Forest plot showing the effect of odanacatib on TH BMD. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 6
Fig. 6
Forest plot showing the effect of odanacatib on trochanter BMD. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 7
Fig. 7
Forest plot showing the effect of odanacatib on distal BMD. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 8
Fig. 8
Forest plot showing the effect of odanacatib on P1NP. A. After 12 months of treatment. B. After 24 months of treatment
Fig. 9
Fig. 9
Forest plot showing the effect of odanacatib on uNTx/Cr. A. After 12 months of treatment. B. After 24 months of treatment
See this image and copyright information in PMC

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