Safety of denosumab versus zoledronic acid in the older adults with osteoporosis: a meta-analysis of cohort studies

Li, Weiwei; Ning, Zeqiong; Yang, Zhifu; Fan, Tingting; Zhang, Wei; Wang, Mingming; Wen, Aidong; Wang, Jingwen

doi:10.1007/s11657-022-01129-2

Cited by 4 publications

(2 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Denosumab is also reported to have a lower incidence of cardiac events compared with bisphosphonates. 17 Our disproportionality results support these findings. However, diabetes was not associated with the risk of cardiac or cerebrovascular events in romosozumab users.…”

Section: Discussionsupporting

confidence: 82%

Evaluation of Risk of Cardiac or Cerebrovascular Events in Romosozumab Users Focusing on Comorbidities: Analysis of the Japanese Adverse Drug Event Report Database

Kotake

Mitsuboshi

Omori

et al. 2022

Journal of Pharmacy Technology

View full text Add to dashboard Cite

Background: Romosozumab is associated with an increased risk of cardiac or cerebrovascular events. Identifying the risk factors for these events could contribute to the safe use of romosozumab. Objective: This study aimed to investigate risk factors for cardiac or cerebrovascular events in romosozumab users. Methods: First, disproportionality analysis was performed to compare the frequency of cardiac or cerebrovascular events, using data from the Japanese Adverse Drug Event Report database. Next, multivariate logistic analysis was performed to investigate risk factors for cardiac or cerebrovascular events in romosozumab users. Results: In total, 859 romosozumab users were identified. A disproportionality of both cardiac and cerebrovascular events was observed in only romosozumab users. Multivariate logistic analysis revealed that the risk of cardiac events in romosozumab users was significantly increased in patients with cardiac disease (odds ratio [OR]: 5.9, 95% confidence interval [CI] 3.5-9.9; P < 0.01) and hypertension (OR: 1.6, 95% CI 1.0-2.7; P = 0.047). In addition, the risk of cerebrovascular events in romosozumab users was significantly increased in the presence of cerebrovascular disease (OR: 2.7, 95% CI 1.2-6.2; P = 0.02) and hypertension (OR: 2.6, 95% CI 1.7-3.9; P < 0.01). Conclusion: Our findings suggest that hypertension may increase the risk of cardiac or cerebrovascular events in romosozumab users. Although additional studies are needed to assess other associated factors, these findings may contribute to the appropriate use of romosozumab and limit adverse events.

show abstract

Section: Discussionsupporting

confidence: 82%

Evaluation of Risk of Cardiac or Cerebrovascular Events in Romosozumab Users Focusing on Comorbidities: Analysis of the Japanese Adverse Drug Event Report Database

Kotake

Mitsuboshi

Omori

et al. 2022

Journal of Pharmacy Technology

View full text Add to dashboard Cite

show abstract

“…Recent meta-analysis demonstrated that denosumab is as safe as zoledronic acid and may be a better option for the population with cardiovascular disease. 27 In the present study, we did not observe any differences in serious adverse events in denosumab versus zoledronic acid users in elderly patients with hip fracture.…”

Section: Discussioncontrasting

confidence: 55%

Denosumab versus zoledronic acid in elderly patients after hip fracture

Kim

Lee

2022

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Background Two injectable anti-osteoporosis medications, denosumab and zoledronic acid, have been widely used to treat patients with severe osteoporosis. The purpose of this study was to evaluate the real-world effectiveness and adherence of denosumab compared to zoledronic acid in geriatric patients after a hip fracture. Methods A total of 282 patients treated with osteoporotic hip fracture between March 2014 and Aug 2022 were retrospectively reviewed. The patients were asked to select the anti-osteoporosis medication after surgery. Treatment persistence was monitored by follow-up visit to the outpatient clinic at postoperative 2 years. Results Of 282 individuals with baseline data, 162 patients took subcutaneous denosumab and 120 patients took intravenous zoledronic acid. At postoperative 2 years, the change in bone mineral density (BMD) from baseline was greater in the denosumab group compared with the zoledronic acid group ( p < 0.001). The rate of persistence to denosumab was significantly higher than that for 12-months zoledronic acid ( p = 0.01). Serious adverse events were similar in the two groups. Conclusions Our study revealed the effectiveness and patients' persistence for two commonly used anti-osteoporosis agents after hip fracture. In this frail, elderly population, half-yearly denosumab was superior to yearly zoledronic acid in BMD and demonstrated significant higher persistence rate, indicating a potential therapeutic advantage that warrants further validation.

show abstract

Difficulties in decision making on a long standing, complicated case of osteoporosis – a real challenge for functional rehabilitation

Stanciu,

Sandru,

Carsote

et al. 2023

Balneo and PRM Research Journal

View full text Add to dashboard Cite

We aim was to present a case of severe osteoporosis with concern to an adult female who was under specific medication against the condition while she experienced inexplicable weight loss in association with an incidental fracture inconsistent with DXA changes. Challenges of the case management and decision making are further on explained. Real-life-medicine poses multiple issues that require an individual decision while respecting the standard protocols. That is why a generalized decision is rather impractical. Here we introduce the clinical case of a lady in her late 60s with a known 6-year history of osteoporosis that required several difficult decisions along surveillance: at first, zoledronic acid represented an available solution, yet after one year, BMD decreased and adjustment was done by initiating a second sequence according to the teriparatide protocol. DXA-BMD, as well as the spectrum of bone turnover markers, qualified the patient as responsive and she further continued with oral bisphosphonates while being monitored via telemedicine amid COVID-19 pandemic. After 24 more months, a second decision of zoledronic acid was done, despite prior partial response, but digestive complains restricted the oral administration of anti-osteoporotic drugs. After one more year, denosumab was initiated and consecutive follow-up is essential. At this point, another challenging aspect was revealed: the discordance between DXA – based scores increase and the presence of an incidental fracture. A supplementary investigation was considered useful (Tc- whole body scintigraphy) noting the clinical presentation with local pain, dysfunctionality, and mild weight loss that also required rehabilitation management.

show abstract

Safety of denosumab versus zoledronic acid in the older adults with osteoporosis: a meta-analysis of cohort studies

Cited by 4 publications

References 31 publications

Evaluation of Risk of Cardiac or Cerebrovascular Events in Romosozumab Users Focusing on Comorbidities: Analysis of the Japanese Adverse Drug Event Report Database

Evaluation of Risk of Cardiac or Cerebrovascular Events in Romosozumab Users Focusing on Comorbidities: Analysis of the Japanese Adverse Drug Event Report Database

Denosumab versus zoledronic acid in elderly patients after hip fracture

Difficulties in decision making on a long standing, complicated case of osteoporosis – a real challenge for functional rehabilitation

Contact Info

Product

Resources

About