Efficacy of denosumab in treatment of osteoporosis in patients receiving maintenance hemodialysis

Sun Li-na; Wang Yun-fei; Sun Fu-yun; Xu Hai-ping; Ma Xiao-ying; Jia Li-li; Liu Wen-min

doi:10.3969/j.issn.1672-8157.2025.01.008

Abstract：Objective To explore the clinical effect of denosumab for osteoporosis in patients receiving maintenance he-modialysis.Methods According to the random number method,96 patients receiving long-term maintenance hemodialysis who had osteoporosis in Cangzhou Central Hospital from February 2021 to June 2023 were randomly divided into the denos-umab group(n=48)and conventional treatment group(n=48).The patients in the conventional treatment group were given con-ventional treatment while those in the denosumab group were given denosumab and conventional treatment.Clinical efficacy,adverse reactions,parathyroid hormone(PTH),blood calcium(Ca),blood phosphorus(P),alkaline phosphatase(ALP),bone mineral density and degree of bone pain were observed and recorded in each group.Results The total effective rate of the de-nosumab group was 93.75%(45/48),which was higher than that of 72.92%(35/48)in the conventional treatment group,and the difference was statistically significant(χ2=7.500,P=0.006).The levels of Ca,P and ALP in the denosumab group((2.01±0.32)mmol·L-1,(1.51±0.17)mmol·L-1,(120.63±4.52)U·L-1,respectively)after treatment were lower than those in the conventional treatment group((2.16±0.36)mmol·L-1,(1.69±0.19)mmol·L-1,(126.55±5.17)U·L-1),the differences were statistically signif-icant(t=-2.158,-4.891,-5.973,P=0.034,P<0.001,P<0.001).After treatment,the iPTH level of the denosumab group was(369.85±81.39)pg·mL-1,which had no significant change compared with that of the conventional treatment group((367.96±81.88)pg·mL-1)(t=0.113,P=0.910).Bone mineral density(BMD)of the denosumab group after treatment was(1.05±0.06)g·cm-2,which was higher than that of the conventional treatment group((0.85±0.06)g·cm-2),and the difference was statistically significant(t=16.330,P<0.001).The VAS score of the denosumab group after treatment was(2.16±0.18)points,which was lower than that of(3.46±0.25)points in the conventional treatment group(t=-29.237,P<0.001).The incidence of adverse reactions in the denosumab group was 12.50%(6/48),which was not significantly different from that of 8.33%(4/48)in the conventional treatment group(χ2=0.447,P=0.504).Conclusion Denosumab has a good therapeutic effect in maintenance hemodialysis patients with osteoporosis by improv-ing the disturbance of calcium and phosphorus metabolism,increasing bone mineral density and alleviating bone pain symptoms.Mean-while,it has no obvious adverse reactions.