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已发表论文
地诺单抗与唑来膦酸在绝经后曾接受阿仑膦酸盐治疗的女性中的临床效益：一项为期两年的回顾性研究
Authors Wang Z, Mei Y, Shen L, Gu J, Ren N, Wang Y, Zhang Z, Wang C
Received 23 May 2025
Accepted for publication 31 October 2025
Published 15 November 2025 Volume 2025:19 Pages 10135—10148
DOI https://doi.org/10.2147/DDDT.S533224
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Georgios Panos
Ziyuan Wang,1,* Yazhao Mei,1,* Li Shen,2 Jiemei Gu,1 Na Ren,1 Ya Wang,1 Zhenlin Zhang,1 Chun Wang1
1Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Clinical Research Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chun Wang, Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yi-Shan Road, Shanghai, 200233, People’s Republic of China, Email wangchun66@sjtu.edu.cn Zhenlin Zhang, Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yi-Shan Road, Shanghai, 200233, People’s Republic of China, Email zhangzl@sjtu.edu.cn
Purpose: Due to various clinical considerations, postmenopausal osteoporosis patients initially treated with oral alendronate (ALN) therapy can later transition to either Denosumab (Dmab) or Zoledronate (ZOL). Using a two-year retrospective cohort, this study sought to thoroughly assess and contrast the frequency of osteoporotic fractures and fluctuations in bone mineral density (BMD) among patients switching from ALN therapy to either Dmab or ZOL.
Patients and Methods: This retrospective cohort study enrolled 294 postmenopausal osteoporosis patients who transitioned from oral ALN to either Dmab or ZOL. The primary endpoint was new-onset osteoporotic fractures within 24 months, confirmed via clinical records and imaging (X-ray/CT/MRI). Secondary endpoint included annual percentage changes in BMD at the lumbar spine, total hip, and femoral neck.
Results: There were no discernible variations between the Dmab and ZOL groups in terms of baseline BMD or prior fracture history. The median age of the Dmab group was higher than that of the ZOL group. In comparison to the ZOL group, the overall incidence of new-onset fractures was significantly lower in the Dmab group (3.79% vs 10.39%, raw p value = 0.028; FDR-adjusted p value = 0.028), especially for vertebral fractures (1.52% vs 8.44%, raw p value = 0.023; FDR-adjusted p value = 0.028). Furthermore, although BMD increased from baseline in both groups, the Dmab group improved much more than the ZOL group.
Conclusion: In postmenopausal osteoporosis patients transitioning from oral ALN to other antiresorptive therapies, Dmab is demonstrated superior efficacy over ZOL in lowering risk of new-onset vertebral and overall fractures and sustaining BMD improvements over 24 months. These findings suggest that Dmab may represent a preferential strategy for optimizing clinical outcomes in sequential anti-osteoporosis treatment protocols.
Keywords: transitioned therapy, denosumab, zoledronate, new-onset fracture
1Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Clinical Research Center, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Chun Wang, Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yi-Shan Road, Shanghai, 200233, People’s Republic of China, Email wangchun66@sjtu.edu.cn Zhenlin Zhang, Shanghai Clinical Research Center of Bone Disease, Department of Osteoporosis and Bone Diseases, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yi-Shan Road, Shanghai, 200233, People’s Republic of China, Email zhangzl@sjtu.edu.cn
Purpose: Due to various clinical considerations, postmenopausal osteoporosis patients initially treated with oral alendronate (ALN) therapy can later transition to either Denosumab (Dmab) or Zoledronate (ZOL). Using a two-year retrospective cohort, this study sought to thoroughly assess and contrast the frequency of osteoporotic fractures and fluctuations in bone mineral density (BMD) among patients switching from ALN therapy to either Dmab or ZOL.
Patients and Methods: This retrospective cohort study enrolled 294 postmenopausal osteoporosis patients who transitioned from oral ALN to either Dmab or ZOL. The primary endpoint was new-onset osteoporotic fractures within 24 months, confirmed via clinical records and imaging (X-ray/CT/MRI). Secondary endpoint included annual percentage changes in BMD at the lumbar spine, total hip, and femoral neck.
Results: There were no discernible variations between the Dmab and ZOL groups in terms of baseline BMD or prior fracture history. The median age of the Dmab group was higher than that of the ZOL group. In comparison to the ZOL group, the overall incidence of new-onset fractures was significantly lower in the Dmab group (3.79% vs 10.39%, raw p value = 0.028; FDR-adjusted p value = 0.028), especially for vertebral fractures (1.52% vs 8.44%, raw p value = 0.023; FDR-adjusted p value = 0.028). Furthermore, although BMD increased from baseline in both groups, the Dmab group improved much more than the ZOL group.
Conclusion: In postmenopausal osteoporosis patients transitioning from oral ALN to other antiresorptive therapies, Dmab is demonstrated superior efficacy over ZOL in lowering risk of new-onset vertebral and overall fractures and sustaining BMD improvements over 24 months. These findings suggest that Dmab may represent a preferential strategy for optimizing clinical outcomes in sequential anti-osteoporosis treatment protocols.
Keywords: transitioned therapy, denosumab, zoledronate, new-onset fracture