Cost-effectiveness of denosumab in the treatment of postmenopausal osteoporosis in Canada

Chau, Diane; Becker, DL; Coombes, Megan; Ioannidis, George; Adachi, Jonathan D.; Goeree, Ron

doi:10.3111/13696998.2012.737393

Cited by 27 publications

(41 citation statements)

References 40 publications

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“…Since the RANKL/RANK/OPG system functions in numerous tissues and its disorder is associated with multiple diseases, it presents a significant potential therapeutic target. A series of pharmacological experiments have been performed, the results of which indicated that OPG-and RANK-Fc inhibited bone loss in models of sex-steroid deficiency, glucocorticoid-induced osteoporosis, RA, multiple myeloma and metastatic bone disease (71,72). However, OPG-and RANK-Fc have not been taken to further clinical trial stages due to concerns regarding potential side effects on the immune system (43).…”

Section: Resultsmentioning

confidence: 99%

Receptor activator of nuclear factor-κB ligand (RANKL)/RANK/osteoprotegerin system in bone and other tissues (Review)

Liu

Zhang

2014

Molecular Medicine Reports

185

124

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The receptor activator of nuclear factor‑κB ligand (RANKL)/RANK/osteoprotegerin (OPG) system was identified in the late 1990s, ending the search for the specific factors expressed by osteoblasts and stromal cells in order to regulate osteoclastogenesis. The identification of the RANKL/RANK/OPG system was a breakthrough in bone biology; however, the system not only works as a dominant mediator in osteoclast activation, formation and survival, but also functions in other tissues, including the mammary glands, brain and lymph nodes. Evidence has indicated that the existence of the RANKL/RANK/OPG system in these tissues suggests that it may have specific functions beyond those in bone. Disorders of the RANKL/RANK/OPG system are associated with certain human diseases, including postmenopausal osteoporosis, rheumatoid arthritis (RA), bone tumors and certain bone metastatic tumors. Genetic studies have indicated that the RANKL/RANK/OPG system may be a key regulator in the formation of lymph nodes and in the autoimmune disease RA, which further suggests that the immune system may interact with the RANKL/RANK/OPG system. The present review aimed to provide an overview of the role of the RANKL/RANK/OPG system in osteoclastogenesis, bone disease and tissues beyond bone.

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Section: Resultsmentioning

confidence: 99%

Receptor activator of nuclear factor-κB ligand (RANKL)/RANK/osteoprotegerin system in bone and other tissues (Review)

Liu

Zhang

2014

Molecular Medicine Reports

185

124

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“…After the first test, 80 % of patients visited their primary care physician, based on a survey of patients in the screening program. We assumed patients receiving osteoporosis treatment had a DXA test every 2 years and saw their primary care physician once a year to monitor their treatment, consistent with a previous Canadian costeffectiveness model evaluating bisphosphonates [24].…”

Section: Costs Of Bone Mineral Density Testing and Osteoporosis Treatmentioning

confidence: 98%

Cost-effectiveness of a fracture liaison service—a real-world evaluation after 6 years of service provision

et al. 2015

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“…The cost-effectiveness of denosumab in postmenopausal osteoporotic women has been evaluated by estimating expected cost and quality-adjusted life-years. Analyses have shown that denosumab represented good value-for-money in postmenopausal women with low bone mass compared with no treatment 80 or treatment with oral bisphosphonates,81–83 and, therefore, has the potential to be a first-line treatment for postmenopausal osteoporotic women. In addition, the cost-effectiveness of denosumab is favorable, particularly for patients at high risk of fracture and low expected adher ence to oral treatments 84.…”

Section: Resultsmentioning

confidence: 99%

A review of denosumab for the treatment of osteoporosis

Miyazaki¹,

Tokimura²,

Tanaka³

2014

PPA

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Osteoporosis is an age-related systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility. Bone remodeling involves two types of cells: osteoblasts and osteoclasts. Receptor activator of nuclear factor-κB ligand (RANKL) is a key regulator of the formation and function of bone-resorbing osteoclasts, and its cell surface receptor, receptor activator of nuclear factor-κB (RANK), is expressed by both osteoclast precursors and mature osteoclasts. Denosumab is a fully human monoclonal anti-RANKL antibody that inhibits the binding of RANKL to RANK, thereby decreasing osteoclastogenesis and bone-resorbing activity of mature osteoclasts. Although there are many medications available for the treatment of osteoporosis, inhibition of RANKL by denosumab has been shown to significantly affect bone metabolism. Denosumab appears to be a promising, highly effective, and safe parenteral therapy with good adherence for osteoporosis. Moreover, denosumab may be cost-effective therapy compared with existing alternatives. Therefore, in this review, we focus on studies of denosumab and the risks and benefits identified for this type of treatment for osteoporosis.

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Cost-effectiveness of denosumab in the treatment of postmenopausal osteoporosis in Canada

Cited by 27 publications

References 40 publications

Receptor activator of nuclear factor-κB ligand (RANKL)/RANK/osteoprotegerin system in bone and other tissues (Review)

Receptor activator of nuclear factor-κB ligand (RANKL)/RANK/osteoprotegerin system in bone and other tissues (Review)

Cost-effectiveness of a fracture liaison service—a real-world evaluation after 6 years of service provision

A review of denosumab for the treatment of osteoporosis

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