Denosumab and zoledronic acid therapy improves BMD in periprosthetic bone

MEDLINE, Embase, PubMed, the Cochrane Central Register of Controlled Trials, and the Web of Science were all thoroughly searched from 1980 to 2022 for randomized controlled trials (RCTs) including ZA or denosumab with THA. The Cochrane Review Manager 5 (RevMan) version 5.41 carried out the meta-analysis. For methodological quality and overall evidence quality, the Cochrane Risk of Bias Tool and GRADEpro were used, respectively.

The key findings of this study were:

1. Finally, 480 individuals from nine RCTs were enrolled and examined.

2. The patients in the intervention group experienced significantly less periprosthetic BMD loss in Gruen zone 7 at 3 months (MD = 4.30, 95% CI: 1.78-6.82, P = 0.0008), 6 months (MD = 7.71, 95% CI: 5.41-10.02, P 0.00001), and 12 months (MD = 8.19, 95% CI: 5.97-10.42,P < 0.00001) after THA than the patients in the control group.

3. There were no reported severe adverse events (AEs).

The authors advocate ZA or denosumab therapy for periprosthetic bone mineral density loss in the present study based on evidence on the effectiveness and safety of ZA and denosumab.

Reference:

Li, X., Han, J., Shi, X., Bi, Z., & Liu, J. (2023). Zoledronic acid and denosumab for periprosthetic bone mineral density loss after joint arthroplasty: a systematic review and meta-analysis of randomized controlled trials. In Archives of Osteoporosis (Vol. 18, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1007/s11657-023-01227-9