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Denosumab improves glucose parameters in patients with impaired glucose tolerance: a systematic review and

Blanca T Pacheco-Soto1, Rebeca Garazi Elguezabal-Rodelo1, Leonardo M Porchia2

  • 1Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.

Journal of Drug Assessment
|October 22, 2021
PubMed
Abstract

Insights

Denosumab, an inhibitor of Receptor Activator of NF-κβ ligand (RANKL), significantly improved fasting plasma glucose and insulin resistance. This effect was more pronounced in individuals with impaired glucose tolerance, suggesting its potential for managing pre-diabetes and diabetes.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Receptor activator of NF-κβ ligand (RANKL) plays a key role in hepatic insulin resistance and impaired glucose uptake.
  • Inhibiting RANKL with Denosumab presents a potential therapeutic strategy for improving glycemic control.

Purpose of the Study:

  • To systematically review the effects of Denosumab on key glycemic parameters.
  • To evaluate Denosumab's efficacy in improving fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting plasma insulin (FPI), and Homeostatic Model Assessment for Insulin Resistance (HOMA1-IR).

Main Methods:

  • A systematic review of studies investigating Denosumab's impact on glycemic markers.
  • Searches conducted across PubMed, SCOPUS, EBSCO, and LILACS databases.
  • Pooled analysis of standard difference in means (SDM) and 95% confidence intervals (95%CI), stratified by glucose tolerance status (Normal Glucose Tolerance vs. Impaired Glucose Tolerance).

Main Results:

  • Denosumab treatment was significantly associated with reduced FPG and HOMA1-IR.
  • Improvements in FPG, HbA1c, and HOMA1-IR were observed in the Impaired Glucose Tolerance (IGT) group.
  • A time-dependent decrease in HbA1c was noted with Denosumab therapy.

Conclusions:

  • Denosumab demonstrates significant efficacy in improving glycemic parameters, particularly in individuals with compromised glucose tolerance.
  • These findings suggest Denosumab as a potential therapeutic agent for enhancing glucose metabolism in patients with pre-diabetes and diabetes.
Keywords:
DenosumabDiabetesHOMA1-IRHbA1cRANKL

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