{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:25Z","timestamp":1785301405317,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore and compare the clinical efficacy and safety of denosumab versus zoledronic acid for the treatment of primary osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 413 primary osteoporosis patients (denosumab,\n                      <jats:italic>n<\/jats:italic>\n                      = 198; zoledronic acid,\n                      <jats:italic>n<\/jats:italic>\n                      = 215). All received daily calcium (600 mg) and vitamin D (400 IU), representing the total combined daily intake from diet and supplements. The denosumab group received subcutaneous denosumab 60 mg every 6 months and the zoledronic acid group annual intravenous zoledronic acid 5 mg over 36 months. Outcomes assessed at baseline and after 36 months included bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip; bone turnover markers \u03b2-CTX (\u03b2-isomerized C-terminal telopeptide of type I collagen) and P1NP (procollagen type I N-terminal propeptide); pain severity using the Visual Analog Scale (VAS); functional impairment using the Oswestry Disability Index (ODI); and incidence of adverse reactions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 36 months, BMD at all sites significantly increased from baseline in both groups (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The denosumab group demonstrated greater mean absolute increases in BMD at the lumbar spine (0.13 \u00b1 0.10 vs. 0.10 \u00b1 0.10 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), femoral neck (0.14 \u00b1 0.06 vs. 0.12 \u00b1 0.05 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and total hip (0.09 \u00b1 0.12 vs. 0.05 \u00b1 0.09 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) compared to the zoledronic acid group. Both groups showed significant decreases in \u03b2-CTX and P1NP levels (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), with the denosumab group exhibiting a greater reduction in \u03b2-CTX (\u22120.54 \u00b1 0.47 vs. \u22120.34 \u00b1 0.44 ng\/mL,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and P1NP (\u221223.68 \u00b1 5.44 vs. \u221219.98 \u00b1 5.28 ng\/mL,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). VAS and ODI scores improved significantly in both groups (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), with a greater reduction in the VAS score in the denosumab group (\u22125.17 \u00b1 1.58 vs. \u22124.61 \u00b1 1.48,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The overall incidence of adverse reactions was lower in the denosumab group compared to the zoledronic acid group (5.56% vs. 20.00%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.008). Adverse events were collected via passive EMR retrieval (see Methods).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Over 36 months, both agents were effective. Denosumab was associated with greater BMD gains, stronger bone resorption suppression, and fewer recorded adverse reactions. These findings are hypothesis-generating and await prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1842793","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:44:14Z","timestamp":1785300254000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Denosumab versus zoledronic acid for primary osteoporosis: a 36-month retrospective cohort study on bone mineral density changes"],"prefix":"10.3389","volume":"13","author":[{"given":"Xin","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning","place":["Guangxi, China"]},{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomeng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxin","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Automation, Guangxi University of Science and Technology, Liuzhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyan","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Hezhou Guangji Hospital, Hezhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangjun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning","place":["Guangxi, China"]},{"name":"Department of Bone and Joint Surgery, The First Affiliated Hospital of Guangxi University of Science and Technology, Guangxi University of Science and Technology, Liuzhou","place":["Guangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.1007\/s00198-021-05900-y","article-title":"The clinician\u2019s guide to prevention and 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