Ha Jeonghoon, Kim Jinyoung, Jeong Chaiho, Lee Jeongmin, Lim Yejee, Baek Ki-Hyun
Division of Endocrinology & Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Endocrinology & Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Arch Osteoporos. 2025 Jan 31;20(1):17. doi: 10.1007/s11657-024-01475-3.
This study compared denosumab and zoledronic acid for treating osteoporosis in drug-naïve postmenopausal Korean women. Over 3 years, both drugs significantly increased bone mineral density. However, denosumab also improved fat-free mass, suggesting it may be a better initial treatment for osteoporosis with low muscle mass, assuming all other conditions remain constant.
Denosumab (DMAB) and zoledronic acid (ZOL), which are strong antiresorptive agents, are used to treat osteoporosis in postmenopause. Nonetheless, the data on their comparative efficacy in drug-naïve patients remain limited. Our research compared the therapeutic efficacy of DMAB and ZOL in drug-naïve postmenopausal Korean women with osteoporosis.
In total, 120 women were enrolled and equally divided to the DMAB and ZOL groups. The bone density and biochemical parameters of the patients were monitored over 3 years. Furthermore, the changes in fat-free mass (FFM), which comprises muscle mass, were assessed by bioelectric impedance analysis. Baseline characteristics, including age, BMI, and the prevalence of fractures, were similar between the groups at the onset of the study. Serum 25(OH), calcium and, phosphorus levels and baseline bone mineral density (BMD) were also comparable between the groups.
Following 3 years of treatment, both groups exhibited a significant increase in BMD versus the baseline value. In particular, BMD increased by 9.7% and 5.1% at the lumber spine and total hip, respectively, in the DMAB group, versus increases of 7.1% and 4.4%, respectively, in the ZOL group. The increase in FFM was greater in the DMAB group. BMI-adjusted FFM decreased by 1.3% in the ZOL group, versus an increase of 3.6% in the DMAB group.
Conclusively, both DMAB and ZOL are effective antiresorptive agents that improved BMD over 3 years in drug-naïve individuals. Moreover, DMAB might represent a more reliable initial option for patients with osteoporosis accompanied by low muscle mass.
本研究比较了地诺单抗和唑来膦酸在初治绝经后韩国女性中治疗骨质疏松症的效果。在3年多的时间里，两种药物均显著提高了骨密度。然而，地诺单抗还改善了去脂体重，这表明在所有其他条件保持不变的情况下，对于肌肉量低的骨质疏松症患者，它可能是一种更好的初始治疗药物。
地诺单抗（DMAB）和唑来膦酸（ZOL）是强效抗吸收剂，用于治疗绝经后骨质疏松症。尽管如此，关于它们在初治患者中的比较疗效的数据仍然有限。我们的研究比较了DMAB和ZOL在初治绝经后韩国骨质疏松症女性中的治疗效果。
总共招募了120名女性，并将她们平均分为DMAB组和ZOL组。对患者的骨密度和生化参数进行了3年的监测。此外，通过生物电阻抗分析评估了包括肌肉量在内的去脂体重（FFM）的变化。在研究开始时，两组的基线特征，包括年龄、体重指数和骨折患病率相似。两组之间的血清25（OH）、钙、磷水平以及基线骨密度（BMD）也具有可比性。
经过3年的治疗，两组的骨密度与基线值相比均显著增加。特别是，DMAB组腰椎和全髋部的骨密度分别增加了9.7%和5.1%，而ZOL组分别增加了7.1%和4.4%。DMAB组的去脂体重增加更大。ZOL组经体重指数调整的去脂体重下降了1.3%，而DMAB组增加了3.6%。
总之，DMAB和ZOL都是有效的抗吸收剂，在初治个体中3年内均改善了骨密度。此外，对于伴有低肌肉量的骨质疏松症患者，DMAB可能是一个更可靠的初始选择。
