A study comparing the efficacy and tolerability of 2 popular osteoporosis drugs, denosumab and zoledronic acid, found that denosumab had a significantly greater effect on increasing spine bone mineral density and zoledronic acid caused more flu-like symptoms. These findings were presented recently at the American Society for Bone and Mineral Research’s annual meeting.
Lead author Kellen Sheedy, a medical student at Loyola University’s Strich School of Medicine, and colleagues performed a retrospective chart review and survey of 107 patients to compare the efficacy, patient satisfaction, cost, and known adverse effects of denosumab versus zoledronic acid, including muscle pain, back pain, and flu-like symptoms. At 1 year, the denosumab and zoledronic acid groups were statistically similar in all areas except spine bone mineral density (increased 0.060 g/cm2 versus 0.021 g/cm2, respectively) and flu-like symptoms (none versus 29% of patients).
Regarding costs, all of the zoledronic acid treatments were covered by insurance and only 2 participants had a copayment ($150 and $1,500); 93% of the denosumab treatments were covered by insurance and 3 participants had a copayment ($70, $200, and $1,800 for 2 treatments).
Overall, the denosumab group (51 patients) had a higher mean increase in spine bone mineral density and the zoledronic acid group (56 patients) had a higher incidence of flu-like symptoms but the 2 groups were statistically similar in patient satisfaction, the researchers reported.
The FDA approved denosumab in 2010 for postmenopausal women with osteoporosis. It is injected subcutaneously (60 mg) every 6 months. The treatment works by inhibiting bone loss and fracture risk.
Zoledronic acid was approved by the FDA in 2007 for osteoporosis. This treatment is administered intravenously (5 mg) once every 12 months. It is the most potent of the drugs in its class, and it works by interfering with the bone-breakdown process.
“This study helped us quantify the efficacy and adverse effects of these 2 drugs providing further guidance for physicians who prescribe these treatments,” said Pauline Camacho, MD, lead study investigator and Director of the Osteoporosis and Metabolic Bone Disease Center at Loyola University Health System. “While this was the first head-to-head comparison of these 2 treatments, larger prospective studies will be needed to confirm these findings.”
Sheedy K, Camara I, Camacho P. Comparison of efficacy, adverse effects and cost of zoledronic acid and denosumab in the treatment of osteoporosis. J Bone Miner Res. 2014;28(Suppl 1). Available at www.asbmr.org/education/AbstractDetail?aid=f66c3659-3ede-47df-a321-1d8a2c75f587. Accessed February 14, 2014.