Safety of denosumab in postmenopausal women with osteoporosis or low bone mineral density: a meta-analysis

Int J Clin Exp Pathol. 2014 Apr 15;7(5):2113-22. eCollection 2014.

Abstract

Purpose: The aim of this meta-analysis was to assess the safety of denosumab in postmenopausal women with osteoporosis or low bone mineral density (BMD).

Methods: Safety of denosumab was compared with placebo or bisphosphonates. A systematic literature search without language restriction was conducted up to January, 2014. The RevMan 5.1 software was used for statistical analysis.

Results: A total of 11 English literatures were eventually identified. The pooled data in the overall analysis revealed that there was no significant difference when compared denosumab with placebo or bisphosphonates in any adverse events (AAE) (RR=0.99, 95% CI=0.98-1.01, p=0.29), serious adverse event (SAE) (RR=1.05, 95% CI=0.98-1.13, p=0.18), neoplasm/cancer (RR=1.14, 95% CI=0.95-1.37, p=0.16) and deaths (RR=0.77, 95% CI=0.57-1.04, p=0.09). However, significant differences were found when compared denosumab with placebo or bisphosphonates in SAE related to infection (RR=1.23, 95% CI=1.00-1.52, p=0.05) and non-vertebral fracture (RR=0.86, 95% CI=0.74-1.00, p=0.05). Subgroup analysis was performed by the type of drugs which was used in the control group. The results of subgroup analysis did not demonstrate the differences between denosumab and bisphosphonates in SAE related to infection (RR=1.13, 95% CI=0.63-2.03) and non-vertebral fracture (RR=1.31, 95% CI=0.87-1.98).

Conclusions: Compared to placebo, denosumab treatment significantly decreased the risk of non-vertebral fracture but increased the risk of SAE related to infection in the postmenopausal women with osteoporosis or low BMD. However, no difference between the safety of denosumab and bisphosphonates was found.

Keywords: Denosumab; meta-analysis; osteoporosis; postmenopausal women.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Age Factors
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bone Density / drug effects*
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Chi-Square Distribution
  • Denosumab
  • Female
  • Humans
  • Odds Ratio
  • Osteoporosis, Postmenopausal / diagnosis
  • Osteoporosis, Postmenopausal / drug therapy*
  • Osteoporosis, Postmenopausal / physiopathology
  • Osteoporotic Fractures / diagnosis
  • Osteoporotic Fractures / physiopathology
  • Osteoporotic Fractures / prevention & control*
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Bone Density Conservation Agents
  • Denosumab