Denosumab versus zoledronic acid in elderly patients after hip fracture. (20th December 2022)

• Record Type: Journal Article
• Authors: Kim, Seung-Ju; Kim, Ji Woon; Lee, Dong-Woo
• Is Part Of: Journal of orthopaedic surgery. Volume 30:Number 3(2022)
• Publication Date: 2022-12-20
• Subjects: denosumab -- zoledronic acid -- hip -- fracture; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/10225536221147082
• Languages: English
• ISSNs: 1022-5536

Abstract

Background: Two injectable anti-osteoporosis medications, denosumab and zoledronic acid, have been widely used to treat patients with severe osteoporosis. The purpose of this study was to evaluate the real-world effectiveness and adherence of denosumab compared to zoledronic acid in geriatric patients after a hip fracture. Methods: A total of 282 patients treated with osteoporotic hip fracture between March 2014 and Aug 2022 were retrospectively reviewed. The patients were asked to select the anti-osteoporosis medication after surgery. Treatment persistence was monitored by follow-up visit to the outpatient clinic at postoperative 2 years. Results: Of 282 individuals with baseline data, 162 patients took subcutaneous denosumab and 120 patients took intravenous zoledronic acid. At postoperative 2 years, the change in bone mineral density (BMD) from baseline was greater in the denosumab group compared with the zoledronic acid group ( p < 0.001). The rate of persistence to denosumab was significantly higher than that for 12-months zoledronic acid ( p = 0.01). Serious adverse events were similar in the two groups. Conclusions: Our study revealed the effectiveness and patients' persistence for two commonly used anti-osteoporosis agents after hip fracture. In this frail, elderly population, half-yearly denosumab was superior to yearly zoledronic acid in BMD and demonstrated significant higher persistence rate, indicating a potential therapeutic advantage that warrants further validation.