狄诺塞麦好用吗？

Denosumab is a fully humanized monoclonal antibody (IgG2 monoclonal antibody) that specifically targets receptor activator of nuclear factor-κB ligand (RANKL). It prevents RANKL from binding to its receptor substances, inhibits osteoclast activation and development, reduces bone resorption, and increases bone density. Is it useful?

This study included a total of 485 adult patients (ECOG score 0-2) who had been diagnosed with bone metastases from solid tumors (mainly breast cancer and non-small cell lung cancer). They were randomly divided into the denosumab group (n = 326, 120 mg, subcutaneous injection, once every 4 weeks) and the zoledronic acid group (n = 159, 4 mg, intravenous injection, once every 4 weeks) in a 2:1 ratio. They were treated for 49 weeks and followed up until 73 weeks. The primary endpoint was the percent change from baseline in urinary creatinine-adjusted urinary collagen cross-linked amino terminal peptide (uNTx/uCr) at 13 weeks, with additional endpoints being the change from baseline in bone-specific alkaline phosphatase (S-BALP) at 13 weeks and time to first bone-related event during the study period.

The results showed that the change in uNTx/uCr was -81.9% in the denosumab group and -75.2% in the zoledronic acid group. There was a significant difference between the two groups. The mean change in S-BALP from baseline was -36.8% in the denosumab group and -30.3% in the zoledronic acid group, with a significant difference between the two groups. The proportion of patients who experienced bone-related events in the first year of the study period was lower in the denosumab group than in the zoledronic acid group. There was no significant difference in the incidence of adverse events between the two groups.

It is not difficult to see from the above research results that denosumab is more effective than zoledronic acid in preventing bone-related events after bone metastasis from solid tumors, and there is no risk of safety. The trial again demonstrated the superiority of denosumab over zoledronic acid in bone metastases from solid tumors.