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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Bone Research
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1407692

Superiority of Denosumab Over Bisphosphonates in Preventing and Treating Glucocorticoid-Induced Osteoporosis: A Systematic Review and Meta-Analysis with GRADE Quality Assessment

Provisionally accepted

    The final, formatted version of the article will be published soon.

      The increasing prevalence of glucocorticoid-induced osteoporosis (GIOP) due to longterm 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.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.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.

      Keywords: Denosumab, Bisphosphonates, Glucocorticoid-induced osteoporosis, bone mineral density, Meta-analysis

      Received: 27 Mar 2024; Accepted: 02 Dec 2024.

      Copyright: © 2024 . This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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