Denosumab vs zoledronic acid: which is best in the real world?

Two common drug therapies for osteoporosis are equally safe and effective, according to a real-world study.

US data from 2,500 matched pairs of patients starting on either denosumab or zoledronic acid showed similar rates of infection, cardiovascular events and osteoporotic fracture over the first year of treatment.

The only difference identified was a higher rate of heart failure with denosumab in patients who were naive to anti-rheumatic biologics. The researchers say this could be a chance finding, although it’s also biologically plausible.

Denosumab can cause hypocalcaemia which in turn could lead to the exacerbation or development of heart failure, they note.

The study authors from from Harvard Medical School and other institutions say although major trials have shown the efficacy of both denosumab and bisphosphonates, there is very little