Effects of romosozumab on bone mineral density and fractures in postmenopausal women: a meta-analysis

Purpose: Romosozumab, a mono-clonal antibody has been approved for the treatment of postmenopausal women with osteoporosis and high fracture risk. This meta-analysis evaluated the effect of romosozumab on Bone Mineral Density (BMD) and fracture occurrence in postmenopausal women with osteoporosis.
Methods: A systematic search was done adhered to the PRISMA guidelines in PubMed, Ovid and Clinicaltrials.gov and eligible studies were selected. The details related to study participants, changes in BMD at the lumber spine (LS), total hip (TH) and femoral neck (FN) and the occurrence of fractures during the period were extracted. The mean differences of BMDs between the two groups and odds ratios (OR) of fractures were considered as the outcome of the studies.
Results: Of the 11 potentially eligible articles, only four studies fulfilled the selection criteria and they were included in the final analysis. Romosozumab therapy for 12 months increased mean BMD at the LS by 12.7% (95% CI, 9.7, 15.6), TH by 4.8% (95% CI, 3.3,6.3) and FN by 4.1% (95% CI, 3.1, 5.2). Treatment with romosozumab decreased the odds of new vertebral fractures and vertebral fractures by 58% (OR=0.42, CI, 0.23,0.91) and 25% (OR=0.75, CI, 0.53,1.06) respectively at the end of 12 months.
Conclusion: Romosozumab significantly increases BMD at LS, TH and FN and reduces the risk of new vertebral and non-vertebral fractures in postmenopausal women with osteoporosis.