Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
2024

Denosumab vs. Bisphosphonates for Osteoporosis from Glucocorticoids

Sample size: 1043 publication Evidence: moderate

Author Information

Author(s): Chen Chiao-Ling, Wang Jian-Ying

Primary Institution: Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan; Department of Pharmacy, New Taipei City Hospital, New Taipei City, Taiwan

Hypothesis

Is denosumab more effective than bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis?

Conclusion

Denosumab is more effective than bisphosphonates in increasing bone mineral density in patients with glucocorticoid-induced osteoporosis while maintaining a similar safety profile.

Supporting Evidence

  • Denosumab showed a significant mean difference in BMD percentage change from baseline at lumbar spine of 2.87%.
  • At the total hip, denosumab had a mean difference of 1.39% compared to bisphosphonates.
  • The safety profile of denosumab was comparable to bisphosphonates with no significant increase in adverse events.

Takeaway

This study found that a medicine called denosumab works better than another medicine called bisphosphonates for people who have weak bones because of steroid use.

Methodology

A systematic review and meta-analysis of randomized controlled trials comparing denosumab and bisphosphonates for glucocorticoid-induced osteoporosis.

Potential Biases

Concerns about bias due to lack of blinding in most studies.

Limitations

The study faced limitations such as heterogeneity among included studies and the need for longer-term research.

Participant Demographics

Participants aged 48.0 to 68.5 years, with varying prior treatments and conditions.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI: 1.86 to 3.87

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3389/fendo.2024.1407692

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