Department of Nephrology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu Province, China.
Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39642. doi: 10.1097/MD.0000000000039642.
Denosumab is an effective drug for the treatment of osteoporosis. This meta-analysis was conducted to evaluate efficacy of denosumab on the treatment of vascular calcification (VC).
Databases including PubMed, EMbase, the Cochrane Library, CNKI, Wanfang database were searched from the inception to January 10th, 2024. Eligible studies comparing denosumab versus no denosumab treatment on VC were included. Data were analyzed using Review Manager Version 5.3.
Five studies were included in this meta-analysis. Three were RCTs and 2 were non-randomized studies. As a whole, 961 patients were included in denosumab group and 890 patients were included in no denosumab group. The follow-up period was from 6 to 36 months. Compared with the no denosumab group, the denosumab group demonstrated a decrease on VC score or area in all enrolled patients (SMD -0.85, 95% CI -1.72-0.02, P = .05). In the subgroup of patients with non-CKD, there was no statistical difference between the denosumab and no denosumab group concerning the change of VC score (SMD -0.00, 95% CI -0.12-0.12, P = .98). In the subgroup of patients with CKD 3b-4, there was no significant difference between the denosumab and no denosumab group concerning the change of VC score (SMD 0.14, 95% CI -0.72-1.00, P = .75). In the subgroup of CKD patients undergoing dialysis, the denosumab group demonstrated a significant decrease on VC score or area compared with the no denosumab group (SMD -2.30, 95% CI -3.78-0.82, P = .002).
Our meta-analysis revealed that denosumab did not show a very definite inhibitory effect on VC. However, denosumab showed the effective effect on inhibiting VC in CKD patients undergoing dialysis. More large RCTs are needed to verify these results.
地舒单抗是一种治疗骨质疏松症的有效药物。本荟萃分析旨在评估地舒单抗治疗血管钙化（VC）的疗效。
检索 PubMed、EMbase、Cochrane 图书馆、中国知网、万方数据库，检索时间截至 2024 年 1 月 10 日。纳入比较地舒单抗与无地舒单抗治疗 VC 的研究。采用 Review Manager Version 5.3 进行数据分析。
本荟萃分析纳入 5 项研究。其中 3 项为 RCT，2 项为非随机研究。共有 961 例患者纳入地舒单抗组，890 例患者纳入无地舒单抗组。随访时间为 6 至 36 个月。与无地舒单抗组相比，地舒单抗组患者的 VC 评分或面积均降低（SMD -0.85，95% CI -1.72-0.02，P=0.05）。在非 CKD 患者亚组中，地舒单抗组与无地舒单抗组患者 VC 评分的变化无统计学差异（SMD -0.00，95% CI -0.12-0.12，P=0.98）。在 CKD 3b-4 患者亚组中，地舒单抗组与无地舒单抗组患者 VC 评分的变化无统计学差异（SMD 0.14，95% CI -0.72-1.00，P=0.75）。在接受透析的 CKD 患者亚组中，地舒单抗组患者的 VC 评分或面积较无地舒单抗组显著降低（SMD -2.30，95% CI -3.78-0.82，P=0.002）。
本荟萃分析显示，地舒单抗对地舒单抗治疗 VC 无明显抑制作用。然而，地舒单抗对透析的 CKD 患者抑制 VC 有效。需要更多的大型 RCT 来验证这些结果。
