PMID- 37016189
OWN - NLM
STAT- MEDLINE
DCOM- 20230522
LR  - 20230620
IS  - 1432-0827 (Electronic)
IS  - 0171-967X (Linking)
VI  - 112
IP  - 6
DP  - 2023 Jun
TI  - The Clinical Effectiveness of Denosumab (Prolia(R)) for the Treatment of 
      Osteoporosis in Postmenopausal Women, Compared to Bisphosphonates, Selective 
      Estrogen Receptor Modulators (SERM), and Placebo: A Systematic Review and Network 
      Meta-Analysis.
PG  - 631-646
LID - 10.1007/s00223-023-01078-z [doi]
AB  - To assess the effectiveness and safety of denosumab (Prolia(R)) compared to 
      bisphosphonates (alendronate, ibandronate, risedronate, zoledronate), selective 
      estrogen receptor modulators (SERMs; bazedoxifene, raloxifene) or placebo, for 
      the treatment of osteoporosis in postmenopausal women (PMW). Systematic searches 
      were run in PubMed, Embase & Cochrane Library on 27-April-2022. Randomized 
      controlled trials (RCTs) that included osteoporotic PMW allocated to denosumab, 
      SERMs, bisphosphonates, or placebo were eligible for inclusion. RCTs were 
      appraised using Cochrane Risk of Bias 2.0. Bayesian network and/or pairwise 
      meta-analyses were conducted on predetermined outcomes (i.e. 
      vertebral/nonvertebral fractures, bone mineral density [BMD], mortality, adverse 
      events [AEs], serious AEs (SAEs), withdrawals due to AEs, AEs caused by denosumab 
      discontinuation). A total of 12 RCTs (k = 22 publications; n = 25,879 
      participants) were included in the analyses. Denosumab, reported a statistically 
      significant increase in lumbar spine (LS) and total hip (TH) BMD, compared to 
      placebo. Similarly, denosumab also resulted in a statistically significant 
      increase in TH BMD compared to the raloxifene and bazedoxifene. However, relative 
      to denosumab, alendronate, ibandronate and risedronate resulted in significant 
      improvements in both femoral neck (FN) and LS BMD. With regards to vertebral 
      fractures and all safety outcomes, there were no statistically significant 
      differences between denosumab and any of the comparator. Relative to placebo, 
      denosumab was associated with significant benefits in both LS and TH BMD. 
      Additionally, denosumab (compared to placebo) was not associated with reductions 
      in vertebral and nonvertebral fractures. Finally, denosumab was not associated 
      with improvement in safety outcomes, compared to placebo. These findings should 
      be interpreted with caution as some analyses suffered from statistical 
      imprecision.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Moshi, Magdalena Ruth
AU  - Moshi MR
AUID- ORCID: 0000-0002-2868-6505
AD  - Research & Evaluation incorporating ASERNIP-S, Royal Australasian College of 
      Surgeons, 24 King William Street, Kent Town, South Australia, 5067, Australia. 
      college.asernip@surgeons.org.
FAU - Nicolopoulos, Konstance
AU  - Nicolopoulos K
AD  - Research & Evaluation incorporating ASERNIP-S, Royal Australasian College of 
      Surgeons, 24 King William Street, Kent Town, South Australia, 5067, Australia.
FAU - Stringer, Danielle
AU  - Stringer D
AD  - Research & Evaluation incorporating ASERNIP-S, Royal Australasian College of 
      Surgeons, 24 King William Street, Kent Town, South Australia, 5067, Australia.
FAU - Ma, Ning
AU  - Ma N
AD  - Research & Evaluation incorporating ASERNIP-S, Royal Australasian College of 
      Surgeons, 24 King William Street, Kent Town, South Australia, 5067, Australia.
FAU - Jenal, Mathias
AU  - Jenal M
AD  - Health Technology Assessment Section, Health Insurance Benefits Division, Health 
      and Accident Insurance Directorate, Federal Office of Public Health (FOPH), Bern, 
      Switzerland.
FAU - Vreugdenburg, Thomas
AU  - Vreugdenburg T
AD  - Research & Evaluation incorporating ASERNIP-S, Royal Australasian College of 
      Surgeons, 24 King William Street, Kent Town, South Australia, 5067, Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20230405
PL  - United States
TA  - Calcif Tissue Int
JT  - Calcified tissue international
JID - 7905481
RN  - 0 (Diphosphonates)
RN  - 0 (Selective Estrogen Receptor Modulators)
RN  - 4EQZ6YO2HI (Denosumab)
RN  - X1J18R4W8P (Alendronate)
RN  - 0 (Bone Density Conservation Agents)
RN  - KM2Z91756Z (Risedronic Acid)
RN  - 4F86W47BR6 (Raloxifene Hydrochloride)
RN  - UMD7G2653W (Ibandronic Acid)
SB  - IM
MH  - Female
MH  - Humans
MH  - Diphosphonates/therapeutic use
MH  - Selective Estrogen Receptor Modulators/therapeutic use
MH  - Denosumab/therapeutic use
MH  - Alendronate/therapeutic use
MH  - *Bone Density Conservation Agents/therapeutic use
MH  - Risedronic Acid/therapeutic use
MH  - Raloxifene Hydrochloride/therapeutic use
MH  - Ibandronic Acid/therapeutic use
MH  - Network Meta-Analysis
MH  - Postmenopause
MH  - *Osteoporosis, Postmenopausal/drug therapy/complications
MH  - *Osteoporosis/drug therapy
MH  - Bone Density
MH  - *Spinal Fractures/complications
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bisphosphonates
OT  - Denosumab
OT  - Network meta-analysis
OT  - Postmenopausal women
OT  - Selective estrogen receptor modulators
OT  - Systematic review
EDAT- 2023/04/05 06:00
MHDA- 2023/05/22 06:42
CRDT- 2023/04/04 23:31
PHST- 2022/09/26 00:00 [received]
PHST- 2022/12/24 00:00 [accepted]
PHST- 2023/05/22 06:42 [medline]
PHST- 2023/04/05 06:00 [pubmed]
PHST- 2023/04/04 23:31 [entrez]
AID - 10.1007/s00223-023-01078-z [pii]
AID - 10.1007/s00223-023-01078-z [doi]
PST - ppublish
SO  - Calcif Tissue Int. 2023 Jun;112(6):631-646. doi: 10.1007/s00223-023-01078-z. Epub 
      2023 Apr 5.