Objective: To evaluate the efficacy and safety of calcitriol combined with denosumab versus calcitriol alone in postmenopausal osteoporosis (PMO). Methods: In this retrospective cohort study, 306 postmenopausal women with PMO were divided into two groups: an intervention group (n = 144) receiving calcitriol, denosumab, and calcium/vitamin D3, and a control group (n = 162) receiving calcitriol and calcium/vitamin D3 only, over 12 months. Outcomes included bone mineral density (BMD), bone turnover markers, calcium-phosphate homeostasis, patient-reported outcomes (VAS, ODI, BI), and adverse events. Results: The intervention cohort demonstrated more pronounced enhancements in BMD measured at the lumbar spine, femoral neck, and total hip (all P < 0.05). Additionally, there was a more marked reduction in bone turnover markers, namely β-C-terminal telopeptide of type I collagen (β-CTX), Tartrate-resistant acid phosphatase 5b (TRACP-5b), Procollagen type I N-terminal propeptide (P1NP), and Bone Gla Protein (BGP) ( P < 0.05). Superior regulation of calcium-phosphate homeostasis—reflected by Parathyroid Hormone (PTH) and 25-hydroxyvitamin D 25(OH)D levels—was also observed in this group ( P < 0.05). Patient-reported outcomes (VAS, ODI, BI) also improved more markedly ( P < 0.05). The incidence of adverse events was low and comparable between groups, with no serious events reported. Conclusion: Calcitriol combined with denosumab synergistically enhances BMD, suppresses bone turnover, improves functional outcomes, and maintains a favorable safety profile in PMO, representing a promising therapeutic strategy. Keywords: postmenopausal osteoporosis, denosumab, calcitriol, bone mineral density, bone turnover markers
Li et al. (Fri,) studied this question.