Five-Year Outcomes of Continuous Zoledronic Acid vs. Denosumab Treatment in Older Men with High Fracture Risk: Effects on Bone Density Improvement and Risk Factor Analysis of Improvement of Bone Density and Incidence of New Fracture.

Denosumab and zoledronic acid are both effective and easily administrable injectable antiosteoporotic medications for postmenopausal women. This study investigated the treatment efficacy of these agents in older male patients with low a bone mass and history of fragility fracture. 175 male patients receiving continuous zoledronic acid treatment and 366 male patients receiving continuous denosumab treatment at our medical center between 2015 and 2020 were included and we analyzed the efficacy of treatment from the improvement in bone mineral density (BMD) and the new-onset low-energy fracture rate after 5 years of continuous medication from their data. BMD significantly improved after 5 years of medication, and higher than 90% patients were satisfied with their treatment medication. Denosumab improved BMD more than zoledronic acid did, especially in patients with T scores higher than -2.5. Smoking, alcohol abuse, diabetes, and inflammatory polyarthritis were associated with poor improvements in BMD. The incidence rate of new fragile fracture was 4.4% and old age was significantly associated with the incidence rate of new fracture. In summary, our study revealed that zoledronic acid and denosumab both significantly increased BMD among older male patients with high fragility fracture rates over a 5-year follow-up. Early medical treatment and lifestyle adjustment were crucial for improving life quality. This article is protected by copyright. All rights reserved.