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

BackgroundThe increasing prevalence of glucocorticoid-induced osteoporosis (GIOP) due to long-term glucocorticoid therapy underscores the need for effective treatment options. Denosumab and bisphosphonates, both key in managing GIOP, require further comparative evaluation to determine their relative...

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Main Authors: Chiao-Ling Chen, Jian-Ying Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1407692/full
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author Chiao-Ling Chen
Jian-Ying Wang
author_facet Chiao-Ling Chen
Jian-Ying Wang
author_sort Chiao-Ling Chen
collection DOAJ
description BackgroundThe increasing prevalence of glucocorticoid-induced osteoporosis (GIOP) due to long-term glucocorticoid therapy underscores the need for effective treatment options. Denosumab and bisphosphonates, both key in managing GIOP, require further comparative evaluation to determine their relative efficacy and safety profiles.MethodsWe conducted a systematic review and meta-analysis, adhering to PRISMA guidelines. Our analysis included randomized controlled trials (RCTs) comparing denosumab with bisphosphonates in GIOP management. The outcomes were percent changes in bone mineral density (BMD) at various sites, bone turnovers markers (BTMs) and the incidence of adverse events.ResultsOur study comprised five RCTs with 1,043 participants. The results showed a significant mean difference in BMD percentage change from baseline at LS of 2.87% (95% CI: 1.86 to 3.87, p<0.001) and at TH of 1.39% (95% CI: 0.15 to 2.64, p=0.03). Additionally, the safety profile of denosumab was found to be comparable to bisphosphonates, with no significant increase in the incidence of adverse events or serious adverse reactions.ConclusionsDenosumab proved more effective in enhancing BMD than bisphosphonates in GIOP, maintaining a comparable safety profile. However, the study’s limitations, including heterogeneity and the need for longer-term research, were noted.
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spelling doaj-art-d97bc18af4d34becb0ddb4502365e01d2024-12-18T05:10:36ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-12-011510.3389/fendo.2024.14076921407692Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessmentChiao-Ling Chen0Jian-Ying Wang1Department of Pharmacy, Taipei City Hospital, Taipei, TaiwanDepartment of Pharmacy, New Taipei City Hospital, New Taipei City, TaiwanBackgroundThe increasing prevalence of glucocorticoid-induced osteoporosis (GIOP) due to long-term glucocorticoid therapy underscores the need for effective treatment options. Denosumab and bisphosphonates, both key in managing GIOP, require further comparative evaluation to determine their relative efficacy and safety profiles.MethodsWe conducted a systematic review and meta-analysis, adhering to PRISMA guidelines. Our analysis included randomized controlled trials (RCTs) comparing denosumab with bisphosphonates in GIOP management. The outcomes were percent changes in bone mineral density (BMD) at various sites, bone turnovers markers (BTMs) and the incidence of adverse events.ResultsOur study comprised five RCTs with 1,043 participants. The results showed a significant mean difference in BMD percentage change from baseline at LS of 2.87% (95% CI: 1.86 to 3.87, p<0.001) and at TH of 1.39% (95% CI: 0.15 to 2.64, p=0.03). Additionally, the safety profile of denosumab was found to be comparable to bisphosphonates, with no significant increase in the incidence of adverse events or serious adverse reactions.ConclusionsDenosumab proved more effective in enhancing BMD than bisphosphonates in GIOP, maintaining a comparable safety profile. However, the study’s limitations, including heterogeneity and the need for longer-term research, were noted.https://www.frontiersin.org/articles/10.3389/fendo.2024.1407692/fulldenosumabbisphosphonatesglucocorticoid-induced osteoporosisbone mineral densitymeta-analysis
spellingShingle Chiao-Ling Chen
Jian-Ying Wang
Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
Frontiers in Endocrinology
denosumab
bisphosphonates
glucocorticoid-induced osteoporosis
bone mineral density
meta-analysis
title Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
title_full Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
title_fullStr Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
title_full_unstemmed Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
title_short Superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid-induced osteoporosis: a systematic review and meta-analysis with GRADE quality assessment
title_sort superiority of denosumab over bisphosphonates in preventing and treating glucocorticoid induced osteoporosis a systematic review and meta analysis with grade quality assessment
topic denosumab
bisphosphonates
glucocorticoid-induced osteoporosis
bone mineral density
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1407692/full
work_keys_str_mv AT chiaolingchen superiorityofdenosumaboverbisphosphonatesinpreventingandtreatingglucocorticoidinducedosteoporosisasystematicreviewandmetaanalysiswithgradequalityassessment
AT jianyingwang superiorityofdenosumaboverbisphosphonatesinpreventingandtreatingglucocorticoidinducedosteoporosisasystematicreviewandmetaanalysiswithgradequalityassessment