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已发表论文
唑来膦酸在停用地舒单抗后序贯治疗骨质疏松症的有效性：一项叙述性综述
Authors Ouyang H, Yang F, Wei W, Wang W
Received 23 June 2025
Accepted for publication 30 October 2025
Published 9 November 2025 Volume 2025:19 Pages 10013—10031
DOI https://doi.org/10.2147/DDDT.S549062
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Prof. Dr. Georgios Panos
Hong Ouyang,1,* Fan Yang,1,* Wenzuo Wei,2 Wei Wang3
1Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, 611137, People’s Republic of China; 2DXR Advanced Clinical Application and Collaboration Center, GE HealthCare, Shanghai, People’s Republic of China; 3Department of Endocrine and Metabolism, Chengdu Seven People’s hospital, Chengdu, 611137, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hong Ouyang, Email 1668846734@qq.com Fan Yang, Email yangfan102522@qq.com
Abstract: Denosumab is a recently developed anti-osteoporosis agent widely applied in the treatment of osteoporosis in postmenopausal women. As a potent inhibitor of bone resorption, it significantly increases bone mineral density, lowers elevated bone turnover rates, and reduces fracture risk. Because denosumab does not bind to the bone matrix, its effects decrease rapidly after discontinuation, a process commonly known as the “rebound effect.” Research has shown that administering zoledronic acid after stopping denosumab can help preserve bone density and reduce the likelihood of vertebral fractures. However, the exact effectiveness of this sequential approach and the factors influencing it, including the duration of prior denosumab treatment, timing, and frequency of zoledronic acid administration, remain insufficiently understood. To address these uncertainties, this review evaluates the effects of sequential zoledronic acid therapy on subsequent changes in bone density, bone turnover markers, fracture risk, and adverse reactions. We also examined in detail the dosage strategies, administration intervals of zoledronic acid, and length of preceding denosumab use across studies, aiming to assist clinicians in designing more evidence-based and clinically relevant sequential treatment protocols.
Keywords: denosumab, zoledronic acid, bone mineral density, bone transformation markers, vertebral fractures
1Department of Endocrine and Metabolism, Geriatric Diseases Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, 611137, People’s Republic of China; 2DXR Advanced Clinical Application and Collaboration Center, GE HealthCare, Shanghai, People’s Republic of China; 3Department of Endocrine and Metabolism, Chengdu Seven People’s hospital, Chengdu, 611137, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hong Ouyang, Email 1668846734@qq.com Fan Yang, Email yangfan102522@qq.com
Abstract: Denosumab is a recently developed anti-osteoporosis agent widely applied in the treatment of osteoporosis in postmenopausal women. As a potent inhibitor of bone resorption, it significantly increases bone mineral density, lowers elevated bone turnover rates, and reduces fracture risk. Because denosumab does not bind to the bone matrix, its effects decrease rapidly after discontinuation, a process commonly known as the “rebound effect.” Research has shown that administering zoledronic acid after stopping denosumab can help preserve bone density and reduce the likelihood of vertebral fractures. However, the exact effectiveness of this sequential approach and the factors influencing it, including the duration of prior denosumab treatment, timing, and frequency of zoledronic acid administration, remain insufficiently understood. To address these uncertainties, this review evaluates the effects of sequential zoledronic acid therapy on subsequent changes in bone density, bone turnover markers, fracture risk, and adverse reactions. We also examined in detail the dosage strategies, administration intervals of zoledronic acid, and length of preceding denosumab use across studies, aiming to assist clinicians in designing more evidence-based and clinically relevant sequential treatment protocols.
Keywords: denosumab, zoledronic acid, bone mineral density, bone transformation markers, vertebral fractures