Efficacy of denosumab versus zoledronate on preventing secondary osteoporotic vertebral compression fracture: a prospective study with 2-year follow-up
Authors' conclusion
Among postmenopausal women with prevalent osteoporotic VCFs, the administration of denosumab versus zoledronate demonstrated superior efficacy in preventing early secondary VCFs within the first year. However, this short-term advantage was not maintained at 24 months, as both agents showed comparable overall morphometric VCF incidence by the end of the study period.
Study context
- Population
- Postmenopausal women with primary osteoporosis who underwent vertebroplasty for osteoporotic vertebral compression fractures (VCFs) at one medical center313 completed follow-up
- Participants
- 155 vs 158
- Comparison
- Denosumab regimen vs zoledronate regimen for 2 years after vertebroplasty
- Denosumab regimen (Den-arm)n = 155
- Zoledronate regimen (Zol-arm)n = 158reference
- Primary endpoint
- Occurrence of new morphometric VCFs on lateral radiographs
Methodological detailsprospective, single-centre
- Prospective
- Single-centre
Primary result
As reported in the abstract
New morphometric VCFs · 24 months
P > 0.05
Secondary outcomes
New morphometric VCFs · 12 months
P = 0.031
New clinical VCFs, Kaplan-Meier cumulative incidence · 24 months
log-rank P = 0.030
- Percent change in lumbar bone mineral density (BMD) from baseline · 6 and 12 months · favoring Den-arm
- P < 0.001 (6 months)
- Percent change in lumbar BMD from baseline · 6 and 12 months · favoring Den-arm
- P < 0.05 (12 months)
- Decrease in bone resorption marker s-CTX from baseline · 3 and 6 months · greater decreases in Den-arm
- P < 0.05
Original publication
Efficacy of denosumab versus zoledronate on preventing secondary osteoporotic vertebral compression fracture: a prospective study with 2-year follow-up. Osteoporos Int. Published 20 May 2026. doi:10.
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