Analysis of the efficacy and safety of denosumab in the treatment of patients with osteoporotic vertebral compression fractures after PVP.

The overall purpose of this study was to explore the efficacy of denosumab in the treatment of osteoporotic vertebral fractures and to compare the efficacy of denosumab in osteoporotic vertebral compression fracture (OVCF) patients with or without a history of osteoporotic fractures. We included 70 patients with single-segment OVCFs who underwent percutaneous vertebral plasty (PVP) at our hospital between October 2020 and April 2022. All postoperative patients received one year of anti-osteoporosis treatment, adopting conventional basic treatment methods such as oral calcium and vitamin D supplements, with subcutaneous injections of denosumab at 60 mg/time every six months (for a total of two times). Patients were grouped on the basis of whether they had previously experienced osteoporotic fractures, and changes in bone mineral density (BMD) of the lumbar spine and hip before and one year after treatment were recorded. Additionally, changes in the preoperative visual analogue scale (VAS) score for back pain and the Oswestry Disability Index (ODI) were observed, as were adverse drug reaction and recurrent fracture incidences. Anterior and posterior vertebral height and sagittal Cobb angle changes were measured on anteroposterior and lateral X-ray films before and after treatment. The results revealed that one year after denosumab treatment, the BMD values at all sites were significantly greater in the 70 patients than before treatment (P < 0.05). Both the group with a history of osteoporotic fractures and the group without a history of osteoporotic fractures (predominantly OVCFs) showed improvements in BMD at various sites. Furthermore, compared with a history of osteoporotic fractures, denosumab was more effective at improving the BMD of patients with their first osteoporotic fracture.