地舒单抗治疗骨质疏松效果怎么样？

As the life span of the population increases, the number of patients with postmenopausal osteoporosis (POP) increases year by year. Currently, the most widely used drugs for the treatment of osteoporosis are bisphosphonates. Due to inconvenient dosing regimens, malabsorption and gastrointestinal adverse events, patient compliance problems have become increasingly apparent. It is the first anti-nuclear factor kappa B receptor activator ligand monoclonal antibody drug approved for the treatment of patients with high risk of POP fractures. Subcutaneous injection every 6 months can significantly reduce the risk of vertebral, non-vertebral and hip fractures. Desosumab increases bone mass by inhibiting the production of osteoclasts, has a long action time and is safe. So, how effective is denosumab in treating osteoporosis?

The effect of denosumab in the treatment of osteoporosis

Research purpose: To explore the effect of sequential application of denosumab on bone density and bone markers in postmenopausal osteoporosis (POP) patients from the perspective of evidence-based medicine.

Research methods: Comprehensive search of Wanfang database, VIP database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, PubMed, Embase and theCochraneLibrary, screening and evaluation of published literature on the use of denosumab in the sequential treatment of POP, and included studies for quality assessment.

Research results: 7 documents, a total of 10 studies, involving 1,273 patients were finally included. Meta analysis results show that compared with bisphosphonates and teriparatide, denosumab can effectively improve the lumbar spine bone density of patients after sequential treatment of POP, and the difference is statistically significant. The subgroup analysis results of lumbar spine bone density showed that according to the treatment plan, discontinuing bisphosphonates and switching to denosumab had the best effect; according to the course of treatment, the effect of 1 year of treatment was better; according to the patient's region, the Americas had better effect).

Compared with bisphosphonates and teriparatide, denosumab can significantly reduce the levels of serum bone markers in patients after sequential treatment of POP, and the difference is statistically significant (P<0.05); the difference in the occurrence of adverse reactions is not statistically significant (P>0.05).

Conclusion

In the sequential treatment of POP, compared with bisphosphonates and teriparatide, denosumab can significantly increase lumbar spine bone density and reduce serum bone marker levels.

References

[1] Bao Shaoyu, Sun Jing, Zhang Zhihai. Meta-analysis of denosumab for the sequential treatment of postmenopausal osteoporosis [J]. Chinese Hospital Drug Evaluation and Analysis, 2023, 23(07): 854-858. DOI: 10.14009/j.issn.1672-2124.2023.07.019.

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