狄诺塞麦效果如何呢？

It is the first approved monoclonal antibody that specifically targets RANK ligand. It is a bone resorption inhibitor with a unique mechanism of action. It specifically targets the receptor activator of NF-kB ligand (RANKL), inhibits the activation and development of osteoclasts, reduces bone resorption, and increases bone density.

Denosumab has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of postmenopausal women with osteoporosis who are at high risk for fracture, as defined by a history of osteoporotic fracture or multiple risk factors for fracture; or in patients who have failed or are intolerant to other available osteoporosis treatments. How effective is denosumab?

A phase III clinical trial included people aged ≥18 years who had started taking prednisone at a daily dose of ≥7.5 mg or an equivalent dose of steroids for <3 months, or who had been taking glucocorticoids for ≥3 months. Study subjects aged <50 years must have a history of osteoporotic fractures. People aged ≥50 years who continue to use glucocorticoids require a T score of ≤-2.0 (or ≤-1.0 with a history of fracture). Study subjects were randomized in a 1:1 ratio to receive denosumab 60 mg subcutaneously once every six months, or risedronate sodium 5 mg orally once a day for 24 months, while both received daily calcium and vitamin D supplements.

Results: Among 795 study subjects, 590 completed the study. Denosumab was better than risedronate in detecting BMD at the lumbar spine and hip, both in people who initiated glucocorticoids and in those who continued to use glucocorticoids. In terms of adverse events, there were no significant differences in the occurrence of serious adverse events and fractures between the two treatment groups.

Conclusion: At 24 months of treatment, the effect of improving lumbar spine and hip BMD is better than risedronate. The two drugs are similar in terms of safety. Denosumab may be a new option for the treatment of glucocorticoid-induced osteoporosis.