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

IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Frontiers in Endocrinology Pub Date : 2024-12-18 eCollection Date: 2024-01-01 DOI:10.3389/fendo.2024.1407692
Chiao-Ling Chen, Jian-Ying Wang
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引用次数: 0

Abstract

Background: The 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.

Methods: We 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.

Results: Our 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.

Conclusions: Denosumab 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.

denosumab在预防和治疗糖皮质激素所致骨质疏松症方面优于双膦酸盐:一项系统综述和荟萃分析,并进行GRADE质量评估。
背景:由于长期糖皮质激素治疗,糖皮质激素诱导的骨质疏松症(GIOP)的患病率不断上升,这强调了对有效治疗方案的需求。Denosumab和双膦酸盐都是治疗GIOP的关键,需要进一步的比较评估来确定它们的相对疗效和安全性。方法:我们遵循PRISMA指南进行了系统回顾和荟萃分析。我们的分析包括比较denosumab和双膦酸盐在GIOP治疗中的随机对照试验(rct)。结果是不同部位骨矿物质密度(BMD)的百分比变化,骨转换标志物(BTMs)和不良事件的发生率。结果:我们的研究包括5个随机对照试验,1043名参与者。结果显示,与基线相比,LS时骨密度百分比变化的平均差异为2.87% (95% CI: 1.86 ~ 3.87, pp=0.03)。此外,发现denosumab的安全性与双膦酸盐相当,不良事件或严重不良反应的发生率没有显着增加。结论:在GIOP患者中,Denosumab比双膦酸盐更有效地提高BMD,并保持相当的安全性。然而,该研究的局限性,包括异质性和需要长期研究,也被指出。
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来源期刊
Frontiers in Endocrinology
Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.70
自引率
9.60%
发文量
3023
审稿时长
14 weeks
期刊介绍: Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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