Evidence map›Paper›PMID 39933434›Full record

ArticleEndocrinology and metabolism (Seoul, Korea)2025

Effects of Sequential Anti-Resorptive Agents on Bone Mineral Density Following Denosumab Withdrawal: A Multicenter Real-World Study in Korea (MAXCARE Study).

Jeonghoon Ha, Kyong Yeun Jung, Kyoung Jin Kim, Seong Hee Ahn, Hyo-Jeong Kim, Yoon-Sok Chung

Registry-linked trialAbstract readMulticenter Study
In one paragraph

Article in Endocrinology and metabolism (Seoul, Korea), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07406685 (The Comparison of Ibandronate and Zoledronic Acid After Denosumab Discontinuation), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07406685 phase4recruitingnot on this mapstarted 2026, after this paper: background citation

The Comparison of Ibandronate and Zoledronic Acid After Denosumab Discontinuation: A Randomized Non-inferiority Trial

TypeinterventionalSponsorNational Taiwan University HospitalRan2026 to 2030Enrolled52ConditionsPostmenopausal Osteoporosis, Postmenopausal Osteopenia, Primary Osteoporosis, OsteoporosisArmsIbandronate IV, Zoledronic acid IV
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jeonghoon HaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kyong Yeun JungDivision of Endocrinology and Metabolism, Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Kyoung Jin KimDivision of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Seong Hee AhnDivision of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea.
Hyo-Jeong KimDivision of Endocrinology and Metabolism, Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Yoon-Sok ChungDepartment of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgruoundDenosumab is a potent anti-resorptive agent widely used for osteoporosis. However, its discontinuation results in a 'rebound phenomenon' of rapid bone loss, necessitating transition to alternative anti-resorptive therapies. Despite this, there is limited evidence to guide the selection of the most effective agent, particularly among bisphosphonates. This study aimed to evaluate the efficacy of different anti-resorptive therapies following denosumab discontinuation in a real-world clinical setting.

methodsThis retrospective study included 360 patients (low-dose alendronate/calcitriol combination [MXM, n=118], alendronate [ALD, n=53], risedronate [RIS, n=20], ibandronate [IBN, n=30], zoledronic acid [ZOL, n=106], selective estrogen receptor modulator [SERM, n=33]) who received at least 12 months of post-denosumab anti-resorptive therapy. Bone mineral density (BMD) changes from baseline and fracture patterns were assessed over the treatment period.

resultsBaseline characteristics, including age and body mass index, were comparable across groups, with an average of 4.2 denosumab administrations per patient. The SERM group experienced the greatest BMD decline across all sites. Significant BMD reductions in the lumbar spine and femoral neck and in the femoral neck alone were observed in the IBN and RIS groups, respectively. While BMD decline was also observed in the MXM, ALD, and ZOL groups, these changes were not statistically significant.

conclusionMXM, ALD, and ZOL mitigated BMD loss following denosumab discontinuation. Conversely, RIS, IBN, and SERM did not adequately prevent BMD decline. These findings underscore the importance of selecting the most appropriate sequential antiresorptive therapy in clinical practice to minimize BMD loss and reduce the risk of adverse outcomes.

Indexed as

Bone DensityBone Density Conservation AgentsDenosumabOsteoporosisAgedAged, 80 and overFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRepublic of KoreaRetrospective StudiesWithholding TreatmentBone Density Conservation AgentsDenosumabBone densityDenosumabDiphosphonatesOsteoporosisSelective estrogen receptor modulators

Identifiers

PMID39933434
PMCPMC12602006

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.