Evidence map›Paper›PMID 41924523›Full record

ArticleFrontiers in endocrinology2026

Real-world effectiveness of denosumab compared to teriparatide in patients with severe osteoporosis.

Maria Francesca Birtolo, Alberto Piasentier, Andreea Daniela Dutu, Walter Vena, Emanuela Morenghi, Stella Pigni, Lucrezia Maria Silvana Gentile, Alessandro Fanti, Valentina Vitale, Antonio Pucci and 9 more

Abstract readComparative Study
In one paragraph

Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

19 authors.

Maria Francesca BirtoloDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Alberto PiasentierDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Andreea Daniela DutuDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Walter VenaDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Emanuela MorenghiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Stella PigniDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Lucrezia Maria Silvana GentileDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Alessandro FantiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Valentina VitaleDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Antonio PucciDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Gabriele CapoNeurosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Massimo TomeiNeurosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Carlo BrembillaNeurosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Maurizio FornariNeurosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Andrea LaghiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Letterio Salvatore PolitiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Antonio C BossiEndocrinology and Diabetology Unit, Humanitas Gavazzeni, Bergamo, Italy.
Andrea Gerardo Antonio LaniaDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.
Gherardo MazziottiDepartment of Biomedical Sciences, Humanitas University, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Context: The potent inhibitory action on bone resorption and concomitant stimulatory effect on bone modeling make denosumab (DEN) as a possible alternative to anabolic drugs for treatment of severe osteoporosis. Objective: To compare the real-world effectiveness of DEN and teriparatide (TPTD) in patients with severe osteoporosis. Methods: This retrospective study included 357 patients (300 females, 57 males; mean age 70.2 ± 10.7 years) attending a referral center for osteoporosis in the period between July 2021 and June 2025. All the patients had indications for treatment with TPTD according to the national drug reimbursement criteria. However, 198 patients were treated with TPTD for 24 months, whereas 159 patients received DEN for contraindications to TPTD (110 cases), patient preference (39 cases) or side effects after few doses of the drug (10 cases). Patients were evaluated for clinical/morphometric VFs and non-vertebral fractures (NVFs) at baseline and after 24 months of treatment. Results: During the study period, 34 patients (9.5%) developed new VFs (clinical in 13 cases) and 7 patients (2.0%) experienced NVFs. The risk of new VFs was significantly associated with vertebroplasty procedure (odds ratio 2.409; p=0.037). Moreover, new VFs occurred less frequently in patients treated with TPTD as compared to DEN (12/198 vs. 22/159; p=0.013). In the multivariable analysis, the favorable effect of TPTD on risk of VFs was still significant after correction for vertebroplasty (odds ratio 0.39; confidence interval 95% 0.19-0.83; p=0.014). No significant difference in NVFs was found between DEN and TPTD (2/159 vs. 5/198; p=0.468). Conclusions: This real-world study shows that DEN might be less effective than TPTD in preventing VFs in patients with severe osteoporosis.

Indexed as

Bone Density Conservation AgentsDenosumabOsteoporosisTeriparatideAgedAged, 80 and overBone DensityFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeBone Density Conservation AgentsDenosumabTeriparatidedenosumabfracturesFRAXsevere osteoporosisteriparatidevertebroplasty

Identifiers

PMID41924523
PMCPMC13035712

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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.