Comparative Efficacy of Denosumab and Zoledronic Acid in Osteogenesis Imperfecta: A Meta-Analytic Review
DOI:
https://doi.org/10.17720/y48kck37Abstract
Background: Osteogenesis imperfecta (OI) is a genetic disorder characterized by fragile bones. The condition significantly impacts bone strength. Two commonly used medications are denosumab and zoledronic acid. Denosumab is associated with the risk of hypercalcemia crisis, particularly during treatment initiation. Despite this risk, denosumab has been shown to improve the total hip score. On the other hand, zoledronic acid can cause side effects such as bone pain, fever, and acute-phase reactions.
Methods: We systematically searched electronic databases, including PubMed, Scopus, Elsevier and Cochrane journals, spanning from each database's inception to Aug 26, 2024.Following guidelines specified in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Pooled effect estimates with 95% confidence intervals will be calculated using random-effects model.
Results: This meta-analysis included two studies with a total of 135 patients, evaluating the safety and effectiveness of Denosumab compared to Zoledronic acid in patients with Osteogenesis Imperfecta. Both studies specifically focused on the occurrence of hypercalcemia crises and included a diverse patient population, encompassing both younger and older individuals. The findings revealed that Denosumab was associated with a higher rate of hypercalcemia crises, while Zoledronic acid demonstrated a broader range of side effects. These results provide insight into the differential impact of these treatments on patient safety across various age groups.
Conclusion: This meta-analysis indicates that Denosumab is associated with a higher rate of uncontrolled conditions and an increased risk of hypercalcemia crisis compared to Zoledronic acid. However, Zoledronic acid demonstrates a higher overall incidence of side effects. Additionally, Denosumab shows a superior total hip score compared to Zoledronic acid. It is important to monitor specific investigations, such as parathyroid hormone (PTH) levels and calcium (Ca) levels, after the administration of both drugs to ensure patient safety and optimize treatment outcomes.
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