Three-year longitudinal assessment of denosumab’s efficacy and safety in postmenopausal osteoporosis: a 36-month real-world cohort study

By
Rong-Lin Xia
Chen Li
Li Wang
Ai-Jun Chao
Wei Wei
July 14, 2026

Frontiers In Medicine

Overview

This study evaluates the long-term efficacy and safety of denosumab in postmenopausal women with osteoporosis over 36 months.

Background

Osteoporosis poses a significant health risk, particularly for postmenopausal women, leading to increased fracture risk and morbidity. Denosumab is an antiresorptive therapy that inhibits bone resorption.

Data Highlights

Outcome	Baseline	36 Months	p-value
Lumbar Spine BMD (g/cm²)	0.674 ± 0.120	0.741 ± 0.102	< 0.001
Femoral Neck BMD (g/cm²)	0.526 ± 0.086	0.562 ± 0.079	< 0.001

Key Findings

Significant increase in lumbar spine BMD from 0.674 to 0.741 g/cm² over 36 months (p < 0.001).
Femoral neck BMD increased from 0.526 to 0.562 g/cm² (p < 0.001).
Bone turnover markers β-CTX and PINP showed sustained suppression, indicating reduced bone resorption.
No new fragility fractures or serious adverse events related to injections were reported during the study period.
Mild hypocalcemia occurred in several patients but resolved with monitoring and adjustments.

Clinical Implications

The findings suggest that denosumab is effective in improving BMD and has an acceptable safety profile in a real-world setting. Continuous monitoring and management of adherence are essential for optimal outcomes.

Conclusion

Denosumab treatment over 36 months demonstrates sustained improvements in BMD and a favorable safety profile in postmenopausal women with osteoporosis.