Denosumab more effective in glucocorticoid-induced osteoporosis

Denosumab found superior to risedronate, as measured by increased bone density in the lower spine in glucocorticoid-induced secondary osteoporosis, according to a recent study.

Glucocorticoids, such as prednisone may induce the bone loss called osteoporosis which causes an estimated yearly bone fracture rate of 5 percent. About one in every 100 people in the world takes glucocorticoids long term to treat immune-mediated disease

Kenneth Saag, M.D., the Jane Knight Lowe Professor of Medicine at the University of Alabama at Birmingham.conducted a study to compare the effectiveness of monoclonal antibody denosumab against a standard treatment for glucocorticoid-induced secondary osteoporosis, the bisphosphonate risedronate.

The study was double-blind study which involved 795 patients at 79 health care centers in Europe, Latin America, Asia and North America. Of these, 505 were glucocorticoid-continuing patients who had received glucocorticoids for at least three months, and 290 were glucocorticoid-initiating patients who had received glucocorticoids for less than three months.

Patients were randomly assigned to one of two groups. The denosumab group got a shot of denosumab underneath the skin every six months and took a placebo pill every day. The risedronate group got a placebo shot every six months and took oral risedronate every day.

After 12 months of their 24 months study researchers found that besides the increase in bone density in the superior lumbur spine, denosumab was superior to risedronate for increasing the bone density in the total hip and at the neck of the femur.

To our knowledge, ours is the first large, randomized controlled trial of denosumab in patients with glucocorticoid-induced osteoporosis who were either prevalent glucocorticoid users or newly initiating glucocorticoid therapy," they wrote. "Denosumab could be a useful addition to the treatment armamentarium for glucocorticoid-induced osteoporosis."