Meta-analysis of the effects of denosumab and romosozumab on bone mineral density and turnover markers in patients with osteoporosis

Abstract

PurposeTo assess the alterations in bone mineral density and bone turnover marker concentrations following the administration of denosumab and romosozumab therapies in patients with osteoporosis.MethodsPubMed was searched for studies published until January 28, 2023, that investigated the clinical efficacy and bone turnover marker changes of denosumab and romosozumab in the treatment of osteoporosis, with a minimum follow-up of 3 months in each study. Studies were screened, and data on changes in bone mineral density (BMD), P1NP, and TRACP-5b levels after treatment were extracted and included in the analysis.ResultsSix studies were analyzed. At 3 months after treatment, the romosozumab group showed greater changes in lumbar BMD and bone turnover markers. BMD of total hip and femoral neck was relatively delayed. Beginning at 6 to 12 months, romosozumab showed greater changes in bone mineral density and markers of bone turnover.ConclusionBoth romosozumab and denosumab have antiosteoporotic effects, with greater effects on BMD and bone turnover markers observed within 12 months of romosozumab treatment.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42023395034.

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“…Denosumab and Romosozumab, other osteoanabolic agents, have shown an even greater BMD improvement at the lumbar spine and hip through blockade of the inhibitory effects of sclerostin, which results in an increase in bone formation and decrease in bone resorption [33,34]. Multiple studies have demonstrated superiority of Romosozumab compared to Denosumab for improving BMD at twelve months [35]. However, compared to Denosumab, treatment with Romosozumab is limited to 12 months and cessation is associated with rapid loss of its effects on BMD [36,37].…”