Comparison of Denosumab and Bisphosphonates in Patients With Osteoporosis: A Meta-Analysis of Randomized Controlled Trials

Lyu, Houchen; Jundi, Bakr; Xu, Chang; Tedeschi, Sara K.; Yoshida, Kazuki; Zhao, Sizheng Steven; Nigwekar, Sagar U.; Leder, Benjamin Z.; Solomon, Daniel H.

doi:10.1210/jc.2018-02236

Cited by 67 publications

(61 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although both bisphosphonates including MIN and denosumab are antiresorptive drugs for osteoporosis, pharmacological mechanisms of action and effects differ [20]. Meta-analyses comparing these two drugs indicate an overall greater efficacy of denosumab on bone metabolism [16,21]. Several mechanisms may explain the differential impacts.…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, denosumab is currently one of the first treatment options, as evidenced by the report that sales of denosumab exceed that of each bisphosphonate [15]. Lyu et al performed a meta-analysis of 10 eligible trials including 5361 participants comparing denosumab and bisphosphonates [16]. Denosumab increases BMD more than bisphosphonates at the lumbar spine, total hip, and femoral neck.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical effects of switching from minodronate to denosumab treatment in patients with postmenopausal osteoporosis: a retrospective study

et al. 2020

View full text Add to dashboard Cite

Background: Denosumab is a major treatment option for patients with postmenopausal osteoporosis; however, the evidence for its use is lacking. Therefore, in this 24-month retrospective study, we aimed to evaluate the effects of switching from minodronate (MIN) to denosumab in these patients. Methods: Patients with postmenopausal osteoporosis either switched from MIN to denosumab (Group 1; n = 32) or continued MIN treatment (Group 2; n = 24). Bone mineral density (BMD) of the lumbar spine (L2-L4) and femoral neck was assessed at baseline and every 6 months for 24 months. Serum bonespecific alkaline phosphatase (BAP) and N-terminal telopeptide were measured at baseline, 12 months, and 24 months. Results: Twenty-nine of the 32 patients (90.6%) in group 1 and all patients (24/24) in group 2 completed the 24-month follow-up. Switching from MIN to denosumab (Group 1) significantly increased lumbar BMD at 12, 18, and 24 months (6.1, 7.4, and 9.6%, respectively) and femoral neck BMD at 12, 18, and 24 months (2.8, 3.2, and 3.4%, respectively), whereas MIN continuous treatment (Group 2) showed no significant difference from baseline. Switching therapy also showed a significant decrease in serum BAP from baseline to 12 and 24 months (− 19.3 and − 26.5%, respectively) and serum NTX from baseline to 12 months (− 13.1%), whereas continuous MIN treatment failed to show any significant differences from baseline. Conclusion: Switching from MIN to denosumab in patients with postmenopausal osteoporosis showed clinical benefits with regard to BMD and bone turnover markers in comparison with continuous MIN treatment. It may therefore be a valid treatment option in the clinical setting.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical effects of switching from minodronate to denosumab treatment in patients with postmenopausal osteoporosis: a retrospective study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…(22,27,28) The explanation is likely due to a more potent antiresorptive effect of Dmab compared with bisphosphonates. (29) Most of the women in this trial were healthy aside from osteoporosis. This might affect generalizability to patients with multiple other serious comorbidities or who take multiple medications.…”

Section: Discussionmentioning

confidence: 95%

Standard Versus Cyclic Teriparatide and Denosumab Treatment for Osteoporosis: A Randomized Trial

Cosman

McMahon

Dempster

et al. 2019

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

In the absence of an intervening antiresorptive agent, cyclic administration of teriparatide does not increase bone mineral density (BMD) more than standard daily therapy. Because denosumab is a potent antiresorptive agent with a rapid off‐effect, we hypothesized that it might be the optimal agent to help maximize bone gains with cyclic teriparatide. In this 3‐year protocol, 70 postmenopausal women with osteoporosis were randomized to 18 months of teriparatide followed by 18 months of denosumab (standard) or three separate 12‐month cycles of 6 months of teriparatide followed by 6 months of denosumab (cyclic). BMD (dual‐energy X‐ray absorptiometry [DXA]) measurements of lumbar spine (LS), total hip (TH), femoral neck (FN), and 1/3 radius (RAD) were performed every 6 months and total body bone mineral (TBBM) at 18 and 36 months. Baseline descriptive characteristics did not differ between groups except for a minimal difference in LS BMD but not T‐score (mean age 65 years, mean LS T‐score − 2.7). In the standard group, BMD increments at 36 months were: LS 16%, TH 4%, FN 3%, and TBBM 4.8% (all p < 0.001 versus baseline). In the cyclic group, 36‐month BMD increments were similar: LS 12%, TH 4%, FN 4%, and TBBM 4.1% (all p < 0.001 versus baseline). At 36 months, the LS BMD increase with standard was slightly larger than with cyclic (p = 0.04), but at 18 months, in the cyclic group, there was no decline in RAD or TBBM (p = 0.007 and < 0.001, respectively, versus standard). Although the cyclic regimen did not improve BMD compared with standard at 36 months, there appeared to be a benefit at 18 months, especially in the highly cortical skeletal sites. This could be clinically relevant in patients at high imminent risk of fracture, particularly at nonvertebral sites. © 2019 American Society for Bone and Mineral Research. © 2019 American Society for Bone and Mineral Research.

show abstract

“…The anti-osteoporotic effects of bisphosphonates and denosumab are different: denosumab is more effective and faster in improving bone mass density; but effects of bisphosphonates continue for years after drug discontinuation because they are imbedded in the bone while denosumab discontinuation fully and rapidly reverse its effects on bone markers and bone mineral density [4][5][6]. Denosumab is contraindicated in severe infection, but is preferred in patients with renal failure.…”

Section: Introductionmentioning

confidence: 99%

Differential protective effects of bisphosphonates and denosumab on primary breast cancer risk, potentially to be modified by statins: a retrospective study using electronic health records

Stanoyevitch

Zhang²,

Martínez-Sanz

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The risks of osteoporosis and breast cancer are increasing in elderly women, as well as hyperlipidemia. Bisphosphonates and denosumab are recommended for treatment of osteoporosis, and statins are used for hyperlipidemia. There are different and overlapping pharmacodynamics among bisphosphonates, denosumab and statins. We aim to assess effects of bisphosphonates and denosumab on breast cancer, possibly affected by statins use.Methods: This retrospective cohort is consisted of 97,671 women elder than 50 years with no previous history of malignancy and no cancer other than breast during follow-up, including 778, 2326, 15287 and 7631denosumab, bisphosphonates, statins and hormone for postmenopausal symptoms ever users. Univariate and bivariate analysis, and the Cox Proportional Hazards multi-variate model are performed.Results: Over an average of 3.6 years follow up, the breast cancer risks counted after 365 days of latency are 1.54% (12/778) for denosumab, 0.52% (12/2326) for bisphosphonates, compared to 0.65% (99/15287) in statins ever use group, 0.26% (20/7631) in hormone users for menopausal symptoms and 1.38% (1032/74867) in control group. The significant difference of breast cancer risk between denosumab and bisphosphonates group (p=0.0047) is supported by the Log-rank test (p=0.0004). The multivariate model is in partial agreement with the uni- and bivariate analysis. Further subgroup analysis revealed that concurrent use of statins in denosumab prescribers lowered the breast cancer risk to 0.89% (2/224), but with no significantly change of breast cancer risk in bisphosphonates group (7/919, 0.762%).Conclusion : Our data suggest superior protective effects of bisphosphonates over denosumab on breast cancer risk in elderly women. Statins could potentially exert breast cancer protective effect in denosumab users with no synergistic effect in patients taking bisphosphonates. A large scale study with long term follow up is needed.

show abstract

Comparison of Denosumab and Bisphosphonates in Patients With Osteoporosis: A Meta-Analysis of Randomized Controlled Trials

Cited by 67 publications

References 32 publications

Clinical effects of switching from minodronate to denosumab treatment in patients with postmenopausal osteoporosis: a retrospective study

Clinical effects of switching from minodronate to denosumab treatment in patients with postmenopausal osteoporosis: a retrospective study

Standard Versus Cyclic Teriparatide and Denosumab Treatment for Osteoporosis: A Randomized Trial

Differential protective effects of bisphosphonates and denosumab on primary breast cancer risk, potentially to be modified by statins: a retrospective study using electronic health records

Contact Info

Product

Resources

About