Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates
Summary Transitioning postmenopausal women with osteoporosis from a bisphosphonate to denosumab appears to be safe and more effective at improving BMD than continuing treatment with a bisphosphonate. Introduction We conducted a patient-level pooled analysis of four studies to estimate the efficacy a...
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| Veröffentlicht in: | Osteoporosis international 2020, Vol.31 (1), p.181-191 |
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| creator | Miller, P.D. Pannacciulli, N. Malouf-Sierra, J. Singer, A. Czerwiński, E. Bone, H.G. Wang, C. Huang, S. Chines, A. Lems, W. Brown, J.P. |
| description | Summary
Transitioning postmenopausal women with osteoporosis from a bisphosphonate to denosumab appears to be safe and more effective at improving BMD than continuing treatment with a bisphosphonate.
Introduction
We conducted a patient-level pooled analysis of four studies to estimate the efficacy and safety of transitioning to denosumab vs. continuing bisphosphonate treatment in postmenopausal women who previously received oral bisphosphonates.
Methods
Patients received 60 mg denosumab once every 6 months or a bisphosphonate (oral alendronate, risedronate, ibandronate, or intravenous zoledronic acid). Endpoints were change from baseline in lumbar spine, total hip, femoral neck, and 1/3 radius BMD at month 12, change from baseline in serum CTX-1 and P1NP, and incidence of adverse events.
Results
A total of 2850 randomized patients (1424 bisphosphonate:1426 denosumab) were included in the analysis. Percentage change in BMD was significantly greater (
p
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| doi_str_mv | 10.1007/s00198-019-05233-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2344216746</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2344216746</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-f1527200c7e43251e3f6e4408028ff5b607245a3bd3c37f09dd2e947c23a792e3</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMotlb_gAcJeN6ar900Ryl-QcGLgreQ3U3slnazZnbb7r83tVXBg4dMZpjnfQdehC4pGVNC5A0QQtUkiSUhKeM82R6hIRWxYSpLj9GQKC4TJejbAJ0BLEgUKSVP0YBTKbOMyyHq75yrClP02NQlBuNs22PvcGlrD93K5HgNY5xX0Mz97tWmtYCrGjce2lWEGtOBWeKNjwNugl1XvoNlj9tgI1riTdXOsQ8R-WNyjk6cWYK9OPwj9Hp_9zJ9TGbPD0_T21lScJm2iaMpk4yQQlrBWUotd5kVgkwImziX5hmRTKSG5yWPAkdUWTKrhCwYN1Ixy0foeu_bBP_RWWj1wnehjic140IwmkmRRYrtqSJ4gGCdbkK1MqHXlOhd2nqfto5Ff6Wtt1F0dbDu8pUtfyTf8UaA7wGIq_rdht_b_9h-AohJjYo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2344216746</pqid></control><display><type>article</type><title>Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Miller, P.D. ; Pannacciulli, N. ; Malouf-Sierra, J. ; Singer, A. ; Czerwiński, E. ; Bone, H.G. ; Wang, C. ; Huang, S. ; Chines, A. ; Lems, W. ; Brown, J.P.</creator><creatorcontrib>Miller, P.D. ; Pannacciulli, N. ; Malouf-Sierra, J. ; Singer, A. ; Czerwiński, E. ; Bone, H.G. ; Wang, C. ; Huang, S. ; Chines, A. ; Lems, W. ; Brown, J.P.</creatorcontrib><description>Summary
Transitioning postmenopausal women with osteoporosis from a bisphosphonate to denosumab appears to be safe and more effective at improving BMD than continuing treatment with a bisphosphonate.
Introduction
We conducted a patient-level pooled analysis of four studies to estimate the efficacy and safety of transitioning to denosumab vs. continuing bisphosphonate treatment in postmenopausal women who previously received oral bisphosphonates.
Methods
Patients received 60 mg denosumab once every 6 months or a bisphosphonate (oral alendronate, risedronate, ibandronate, or intravenous zoledronic acid). Endpoints were change from baseline in lumbar spine, total hip, femoral neck, and 1/3 radius BMD at month 12, change from baseline in serum CTX-1 and P1NP, and incidence of adverse events.
Results
A total of 2850 randomized patients (1424 bisphosphonate:1426 denosumab) were included in the analysis. Percentage change in BMD was significantly greater (
p
< 0.001) for denosumab vs. bisphosphonate at each skeletal site; differences in BMD changes ranged from 0.6 to 2.0%. Percentage decrease in serum CTX-1 and P1NP was significantly greater (
p
< 0.0001) for denosumab vs. bisphosphonate at months 1, 6, and 12; in the denosumab group only, percentage change in serum CTX-1 at month 1 was significantly correlated with percentage change in lumbar spine and total hip BMD at month 12. The incidences of adverse events were similar between treatment groups. Three patients (one bisphosphonate and two denosumab) had atypical femoral fractures, all from the denosumab vs. zoledronic acid study.
Conclusion
Postmenopausal women can safely transition from a bisphosphonate to denosumab, which is more effective at improving BMD than continuing with a bisphosphonate.
Clinical trials registration
NCT00377819, NCT00919711, NCT00936897, NCT01732770.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-019-05233-x</identifier><identifier>PMID: 31776637</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Aged ; Alendronic acid ; Bisphosphonates ; Bone Density ; Bone Density Conservation Agents - adverse effects ; Clinical trials ; Denosumab - adverse effects ; Diphosphonates - adverse effects ; Endocrinology ; Female ; Femur ; Fractures ; Hip ; Hormone replacement therapy ; Humans ; Ibandronic acid ; Immunotherapy ; Intravenous administration ; Medicine ; Medicine & Public Health ; Middle Aged ; Monoclonal antibodies ; Original Article ; Orthopedics ; Osteoporosis ; Osteoporosis, Postmenopausal - drug therapy ; Patients ; Post-menopause ; Postmenopause ; Rheumatology ; Risedronic acid ; Spine (lumbar) ; Zoledronic acid</subject><ispartof>Osteoporosis international, 2020, Vol.31 (1), p.181-191</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2019</rights><rights>Osteoporosis International is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-f1527200c7e43251e3f6e4408028ff5b607245a3bd3c37f09dd2e947c23a792e3</citedby><cites>FETCH-LOGICAL-c375t-f1527200c7e43251e3f6e4408028ff5b607245a3bd3c37f09dd2e947c23a792e3</cites><orcidid>0000-0002-5347-7457</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-019-05233-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-019-05233-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31776637$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miller, P.D.</creatorcontrib><creatorcontrib>Pannacciulli, N.</creatorcontrib><creatorcontrib>Malouf-Sierra, J.</creatorcontrib><creatorcontrib>Singer, A.</creatorcontrib><creatorcontrib>Czerwiński, E.</creatorcontrib><creatorcontrib>Bone, H.G.</creatorcontrib><creatorcontrib>Wang, C.</creatorcontrib><creatorcontrib>Huang, S.</creatorcontrib><creatorcontrib>Chines, A.</creatorcontrib><creatorcontrib>Lems, W.</creatorcontrib><creatorcontrib>Brown, J.P.</creatorcontrib><title>Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
Transitioning postmenopausal women with osteoporosis from a bisphosphonate to denosumab appears to be safe and more effective at improving BMD than continuing treatment with a bisphosphonate.
Introduction
We conducted a patient-level pooled analysis of four studies to estimate the efficacy and safety of transitioning to denosumab vs. continuing bisphosphonate treatment in postmenopausal women who previously received oral bisphosphonates.
Methods
Patients received 60 mg denosumab once every 6 months or a bisphosphonate (oral alendronate, risedronate, ibandronate, or intravenous zoledronic acid). Endpoints were change from baseline in lumbar spine, total hip, femoral neck, and 1/3 radius BMD at month 12, change from baseline in serum CTX-1 and P1NP, and incidence of adverse events.
Results
A total of 2850 randomized patients (1424 bisphosphonate:1426 denosumab) were included in the analysis. Percentage change in BMD was significantly greater (
p
< 0.001) for denosumab vs. bisphosphonate at each skeletal site; differences in BMD changes ranged from 0.6 to 2.0%. Percentage decrease in serum CTX-1 and P1NP was significantly greater (
p
< 0.0001) for denosumab vs. bisphosphonate at months 1, 6, and 12; in the denosumab group only, percentage change in serum CTX-1 at month 1 was significantly correlated with percentage change in lumbar spine and total hip BMD at month 12. The incidences of adverse events were similar between treatment groups. Three patients (one bisphosphonate and two denosumab) had atypical femoral fractures, all from the denosumab vs. zoledronic acid study.
Conclusion
Postmenopausal women can safely transition from a bisphosphonate to denosumab, which is more effective at improving BMD than continuing with a bisphosphonate.
Clinical trials registration
NCT00377819, NCT00919711, NCT00936897, NCT01732770.</description><subject>Aged</subject><subject>Alendronic acid</subject><subject>Bisphosphonates</subject><subject>Bone Density</subject><subject>Bone Density Conservation Agents - adverse effects</subject><subject>Clinical trials</subject><subject>Denosumab - adverse effects</subject><subject>Diphosphonates - adverse effects</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Femur</subject><subject>Fractures</subject><subject>Hip</subject><subject>Hormone replacement therapy</subject><subject>Humans</subject><subject>Ibandronic acid</subject><subject>Immunotherapy</subject><subject>Intravenous administration</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Osteoporosis, Postmenopausal - drug therapy</subject><subject>Patients</subject><subject>Post-menopause</subject><subject>Postmenopause</subject><subject>Rheumatology</subject><subject>Risedronic acid</subject><subject>Spine (lumbar)</subject><subject>Zoledronic acid</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gAcJeN6ar900Ryl-QcGLgreQ3U3slnazZnbb7r83tVXBg4dMZpjnfQdehC4pGVNC5A0QQtUkiSUhKeM82R6hIRWxYSpLj9GQKC4TJejbAJ0BLEgUKSVP0YBTKbOMyyHq75yrClP02NQlBuNs22PvcGlrD93K5HgNY5xX0Mz97tWmtYCrGjce2lWEGtOBWeKNjwNugl1XvoNlj9tgI1riTdXOsQ8R-WNyjk6cWYK9OPwj9Hp_9zJ9TGbPD0_T21lScJm2iaMpk4yQQlrBWUotd5kVgkwImziX5hmRTKSG5yWPAkdUWTKrhCwYN1Ixy0foeu_bBP_RWWj1wnehjic140IwmkmRRYrtqSJ4gGCdbkK1MqHXlOhd2nqfto5Ff6Wtt1F0dbDu8pUtfyTf8UaA7wGIq_rdht_b_9h-AohJjYo</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Miller, P.D.</creator><creator>Pannacciulli, N.</creator><creator>Malouf-Sierra, J.</creator><creator>Singer, A.</creator><creator>Czerwiński, E.</creator><creator>Bone, H.G.</creator><creator>Wang, C.</creator><creator>Huang, S.</creator><creator>Chines, A.</creator><creator>Lems, W.</creator><creator>Brown, J.P.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><orcidid>https://orcid.org/0000-0002-5347-7457</orcidid></search><sort><creationdate>2020</creationdate><title>Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates</title><author>Miller, P.D. ; Pannacciulli, N. ; Malouf-Sierra, J. ; Singer, A. ; Czerwiński, E. ; Bone, H.G. ; Wang, C. ; Huang, S. ; Chines, A. ; Lems, W. ; Brown, J.P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-f1527200c7e43251e3f6e4408028ff5b607245a3bd3c37f09dd2e947c23a792e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Alendronic acid</topic><topic>Bisphosphonates</topic><topic>Bone Density</topic><topic>Bone Density Conservation Agents - adverse effects</topic><topic>Clinical trials</topic><topic>Denosumab - adverse effects</topic><topic>Diphosphonates - adverse effects</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Femur</topic><topic>Fractures</topic><topic>Hip</topic><topic>Hormone replacement therapy</topic><topic>Humans</topic><topic>Ibandronic acid</topic><topic>Immunotherapy</topic><topic>Intravenous administration</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Osteoporosis, Postmenopausal - drug therapy</topic><topic>Patients</topic><topic>Post-menopause</topic><topic>Postmenopause</topic><topic>Rheumatology</topic><topic>Risedronic acid</topic><topic>Spine (lumbar)</topic><topic>Zoledronic acid</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miller, P.D.</creatorcontrib><creatorcontrib>Pannacciulli, N.</creatorcontrib><creatorcontrib>Malouf-Sierra, J.</creatorcontrib><creatorcontrib>Singer, A.</creatorcontrib><creatorcontrib>Czerwiński, E.</creatorcontrib><creatorcontrib>Bone, H.G.</creatorcontrib><creatorcontrib>Wang, C.</creatorcontrib><creatorcontrib>Huang, S.</creatorcontrib><creatorcontrib>Chines, A.</creatorcontrib><creatorcontrib>Lems, W.</creatorcontrib><creatorcontrib>Brown, J.P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miller, P.D.</au><au>Pannacciulli, N.</au><au>Malouf-Sierra, J.</au><au>Singer, A.</au><au>Czerwiński, E.</au><au>Bone, H.G.</au><au>Wang, C.</au><au>Huang, S.</au><au>Chines, A.</au><au>Lems, W.</au><au>Brown, J.P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2020</date><risdate>2020</risdate><volume>31</volume><issue>1</issue><spage>181</spage><epage>191</epage><pages>181-191</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
Transitioning postmenopausal women with osteoporosis from a bisphosphonate to denosumab appears to be safe and more effective at improving BMD than continuing treatment with a bisphosphonate.
Introduction
We conducted a patient-level pooled analysis of four studies to estimate the efficacy and safety of transitioning to denosumab vs. continuing bisphosphonate treatment in postmenopausal women who previously received oral bisphosphonates.
Methods
Patients received 60 mg denosumab once every 6 months or a bisphosphonate (oral alendronate, risedronate, ibandronate, or intravenous zoledronic acid). Endpoints were change from baseline in lumbar spine, total hip, femoral neck, and 1/3 radius BMD at month 12, change from baseline in serum CTX-1 and P1NP, and incidence of adverse events.
Results
A total of 2850 randomized patients (1424 bisphosphonate:1426 denosumab) were included in the analysis. Percentage change in BMD was significantly greater (
p
< 0.001) for denosumab vs. bisphosphonate at each skeletal site; differences in BMD changes ranged from 0.6 to 2.0%. Percentage decrease in serum CTX-1 and P1NP was significantly greater (
p
< 0.0001) for denosumab vs. bisphosphonate at months 1, 6, and 12; in the denosumab group only, percentage change in serum CTX-1 at month 1 was significantly correlated with percentage change in lumbar spine and total hip BMD at month 12. The incidences of adverse events were similar between treatment groups. Three patients (one bisphosphonate and two denosumab) had atypical femoral fractures, all from the denosumab vs. zoledronic acid study.
Conclusion
Postmenopausal women can safely transition from a bisphosphonate to denosumab, which is more effective at improving BMD than continuing with a bisphosphonate.
Clinical trials registration
NCT00377819, NCT00919711, NCT00936897, NCT01732770.</abstract><cop>London</cop><pub>Springer London</pub><pmid>31776637</pmid><doi>10.1007/s00198-019-05233-x</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-5347-7457</orcidid></addata></record> |
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| ispartof | Osteoporosis international, 2020, Vol.31 (1), p.181-191 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Alendronic acid Bisphosphonates Bone Density Bone Density Conservation Agents - adverse effects Clinical trials Denosumab - adverse effects Diphosphonates - adverse effects Endocrinology Female Femur Fractures Hip Hormone replacement therapy Humans Ibandronic acid Immunotherapy Intravenous administration Medicine Medicine & Public Health Middle Aged Monoclonal antibodies Original Article Orthopedics Osteoporosis Osteoporosis, Postmenopausal - drug therapy Patients Post-menopause Postmenopause Rheumatology Risedronic acid Spine (lumbar) Zoledronic acid |
| title | Efficacy and safety of denosumab vs. bisphosphonates in postmenopausal women previously treated with oral bisphosphonates |
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