Kim Chul-Ho, Kim Keunho, Kim Ji Wan
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, Republic of Korea.
Osteoporos Int. 2025 Feb;36(2):265-274. doi: 10.1007/s00198-024-07314-y. Epub 2024 Dec 13.
Denosumab significantly increased lumbar spine and total hip bone mineral density in patients with hip fractures, with comparable efficacy to that in other than hip fracture patients. Its effect was more pronounced in medication-naïve patients, suggesting its efficacy regardless of hip fracture status.
Denosumab, a potent antiresorptive agent, has been recognised to increase bone mineral density (BMD) and reduce fracture risk in vertebrae and hips. Despite its widespread use, no sequential follow-up studies have investigated its effects on BMD in patients with hip fractures. This study aimed to analyse the effect of denosumab on BMD gain in patients with hip fractures and investigate the incidence of subsequent hip fractures.
This retrospective study analysed 371 patients treated with denosumab for at least 3 years, including 122 patients with hip fractures. 1:1 propensity score matching was used to compare BMD changes in the lumbar spine, total hip, and femoral neck, as well as additional hip fracture incidence between the hip fracture and the other than hip fracture group. Ultimately, 122 patients in each group were compared. Subgroup analysis compared osteoporosis medication-naïve patients with those with prior medication use.
The hip fracture and other than hip fracture group exhibited significant annual increases in lumbar spine and total hip BMD, with no significant differences between them after matching. The femoral neck BMD increased significantly only in the first year. The incidence of additional hip fractures did not differ significantly between the groups. Moreover, the effect of denosumab on BMD increase was more pronounced in patients without a previous medication history for anti-osteoporosis treatment than in those with such a history.
Denosumab significantly increased lumbar spine and total hip BMD in patients with hip fractures, with comparable efficacy to that in other than hip fracture patients. Its effect was more pronounced in medication-naïve patients, suggesting its efficacy regardless of hip fracture status.
地诺单抗显著提高了髋部骨折患者的腰椎和全髋骨密度，其疗效与非髋部骨折患者相当。在未接受过药物治疗的患者中，其效果更为显著，表明无论髋部骨折状态如何，地诺单抗均有效。
地诺单抗是一种强效抗吸收剂，已被认可可增加骨密度（BMD）并降低椎体和髋部骨折风险。尽管其广泛使用，但尚无序贯随访研究调查其对髋部骨折患者骨密度的影响。本研究旨在分析地诺单抗对髋部骨折患者骨密度增加的影响，并调查随后髋部骨折的发生率。
这项回顾性研究分析了371例接受地诺单抗治疗至少3年的患者，其中包括122例髋部骨折患者。采用1:1倾向评分匹配法比较腰椎、全髋和股骨颈的骨密度变化，以及髋部骨折组和非髋部骨折组之间额外髋部骨折的发生率。最终，对每组122例患者进行了比较。亚组分析比较了未接受过骨质疏松症药物治疗的患者和先前使用过药物的患者。
髋部骨折组和非髋部骨折组的腰椎和全髋骨密度均有显著的年度增加，匹配后两组之间无显著差异。股骨颈骨密度仅在第一年显著增加。两组之间额外髋部骨折的发生率无显著差异。此外，与有抗骨质疏松治疗用药史的患者相比，地诺单抗对骨密度增加的影响在没有抗骨质疏松治疗用药史的患者中更为显著。
地诺单抗显著提高了髋部骨折患者的腰椎和全髋骨密度，其疗效与非髋部骨折患者相当。在未接受过药物治疗的患者中，其效果更为显著，表明无论髋部骨折状态如何，地诺单抗均有效。
