Osteoporosis Drug Could Prevent Glucocorticoid-Induced Fractures

Denosumab may be a safe and effective option for the prevention of glucocorticoid-induced osteoporosis, according to a new study.

For their study, researchers evaluated 795 glucocorticoid-continuing (n = 505) or glucocorticoid-initiating patients (n = 290) aged 18 years and older for 24 months.
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Glucocorticoid participants had been receiving at least 7.5 mg prednisone daily, or equivalent, for at least 3 months, and glucocorticoid-initiating patients had been receiving treatment for less than 3 months prior to screening.

Participants were randomly assigned to treatment with either 60 mg subcutaneous denosumab every 6 months and oral placebo daily for 24 months (n = 398), or 5 mg oral risedronate daily and subcutaneous placebo every 6 months for 24 months (n = 397).

Results demonstrated that denosumab was both noninferior and superior to risedronate at 12 months in regard to their effects on bone mineral density at the lumbar spine in both glucocorticoid-continuing (4.4% vs 2.3%) and glucocorticoid-initiating patients (3.8% vs 0.8%)

The researchers noted that the between-group incidence of adverse events, serious adverse events, and fractures were similar.

“Denosumab could be a useful treatment option for patients newly initiating or continuing glucocorticoids who are at risk of fractures,” the researchers concluded.

—Christina Vogt

Reference:

Saag KG, Wagman RB, Geusens P, et al. Denosumab versus risedronate in glucocorticoid-induced osteoporosis: a multicentre, randomized, double-blind, active-controlled, double-dummy, non-inferiority study [Published online April 6, 2018]. Lancet Diabetes Endocrinol.  https://doi.org/10.1016/S2213-8587(18)30075-5.