Effect of denosumab, an anti-osteoporosis drug, on vascular calcification: A meta-analysis

Denosumab is an effective drug for the treatment of osteoporosis. This meta-analysis was conducted to evaluate efficacy of denosumab on the treatment of vascular calcification (VC).

Databases including PubMed, EMbase, the Cochrane Library, CNKI, Wanfang database were searched from the inception to January 10th, 2024. Eligible studies comparing denosumab versus no denosumab treatment on VC were included. Data were analyzed using Review Manager Version 5.3.

Five studies were included in this meta-analysis. Three were RCTs and 2 were non-randomized studies. As a whole, 961 patients were included in denosumab group and 890 patients were included in no denosumab group. The follow-up period was from 6 to 36 months. Compared with the no denosumab group, the denosumab group demonstrated a decrease on VC score or area in all enrolled patients (SMD -0.85, 95% CI -1.72-0.02, P = .05). In the subgroup of patients with non-CKD, there was no statistical difference between the denosumab and no denosumab group concerning the change of VC score (SMD -0.00, 95% CI -0.12-0.12, P = .98). In the subgroup of patients with CKD 3b-4, there was no significant difference between the denosumab and no denosumab group concerning the change of VC score (SMD 0.14, 95% CI -0.72-1.00, P = .75). In the subgroup of CKD patients undergoing dialysis, the denosumab group demonstrated a significant decrease on VC score or area compared with the no denosumab group (SMD -2.30, 95% CI -3.78-0.82, P = .002).

Our meta-analysis revealed that denosumab did not show a very definite inhibitory effect on VC. However, denosumab showed the effective effect on inhibiting VC in CKD patients undergoing dialysis. More large RCTs are needed to verify these results.