Romosozumab Tops Denosumab in Treating GIOP

TOPLINE:

Romosozumab (Evenity) is superior to denosumab (Prolia) in increasing bone mineral density (BMD) in patients with glucocorticoid-induced osteoporosis (GIOP).

METHODOLOGY:

Romosozumab is a US Food and Drug Administration-approved humanized monoclonal antibody used to treat osteoporosis in postmenopausal women with a high risk for facture.
The study included 70 adults with GIOP with a high-risk for osteoporotic fracture who received a ≥5 mg/day prednisolone dose for at least 12 months prior to the study.
Patients were randomly assigned to receive romosozumab subcutaneously (210 mg) every month for 12 doses or denosumab subcutaneously (60 mg) every 6 months for two doses.
The primary endpoint was the difference in BMD at the lumber spine from baseline to 1 year.

TAKEAWAY:

Patients in the romosozumab group had a significantly greater increase in spine BMD (+7.3%) after 12 months, compared with those in the denosumab group (+2.3%).
Both groups had a similar increase in hip BMD at 1 year, whereas femoral neck BMD did not significantly increase in either group during the study period.
The romosozumab group had a lower drop in serum C-terminal telopeptide of type I collagen (CTX) but showed an increase in procollagen type 1 N propeptide (P1NP), compared with the denosumab group.
Patients in the romosozumab more frequently reported injection site pain, erythema, and swelling.

IN PRACTICE:

“Romosozumab may offer a new treatment option in GIOP in high-risk patients,” write the authors.

STUDY DETAILS:

Chi-Chiu Mok, MD, Tuen Mun Hospital, Hong Kong, led the research and presented abstract OP0246 on June 2 at the European Alliance of Associations for Rheumatology (EULAR) 2023 Annual Meeting.

LIMITATIONS:

The trial’s small sample size could limit the interpretation of the results.

DISCLOSURES:

The study was funded by a small grant from the Health and Medical Research Fund of the Health Bureau of the Government of Hong Kong.

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