Preventing post-denosumab bone loss with zoledronate: a 2-year randomized trial in post-menopausal women without and with pre-exposure to bisphosphonates
Authors' conclusion
Findings support that early and multiple Zol injections are needed better to preserve BMD after stopping Dmab in long-term users.
Study context
- Population
- Post-menopausal women treated with denosumab (Dmab) > 2 years and reaching BMD T-scores > −2.0
- Participants
- 44 women
- Comparison
- Zoledronate at 6 months vs 9 months after last denosumab vs zoledronate if CTX > 644 ng/l or BMD decreased ≥ 5%
- 6 Mn = 12
- 9 Mn = 11
- OBSn = 11
- OBS-BPsn = 10
- Primary endpoint
- Co-primary: lumbar spine BMD changes 1-year post-Zol and frequency of Zol treatments required
- Follow-up
- 1-year post-Zol
Methodological detailsmulticentre, open-label, parallel observational group
- Multicentre
- Open-label
- Parallel observational group
Primary result
As reported in the abstract
- Most post-Dmab patients without previous bisphosphonates (BPs) required multiple zoledronate (Zol) infusions (median 2, range 1-5)
- Most OBS-BPs patients needed only one Zol
- Median LS BMD changes 12 and 24 months post-Zol similar between groups
Further findings
| Outcome | 6 M | 9 M | OBS | OBS-BPs |
|---|---|---|---|---|
| LS BMD change at 12 months after end of last Dmab dose effect | −4.71% | −8.25% | −8.13% | −4.62% |
- LS BMD change at 12 months after end of last Dmab dose effect: numerically larger in 9 M and OBS
Original publication
Preventing post-denosumab bone loss with zoledronate: a 2-year randomized trial in post-menopausal women without and with pre-exposure to bisphosphonates. Osteoporos Int. Published 29 June 2026. doi:10.
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