What question did this study set out to answer?

The study aims to compare the efficacy and safety of calcitriol combined with denosumab to calcitriol alone in postmenopausal osteoporosis.

May 24, 2026Open Access

Synergistic Efficacy of Calcitriol Combined with Denosumab versus Calcitriol Alone in Postmenopausal Osteoporosis: A Retrospective Cohort Study

Key Points

The study aims to compare the efficacy and safety of calcitriol combined with denosumab to calcitriol alone in postmenopausal osteoporosis.
Retrospective cohort study involving 306 postmenopausal women with osteoporosis.
Participants were divided into an intervention group receiving calcitriol and denosumab, and a control group receiving calcitriol only.
Outcomes evaluated include bone mineral density, bone turnover markers, and patient-reported outcomes over 12 months.
The intervention group showed significant improvements in bone mineral density at multiple sites (P < 0.05).
Reduced bone turnover markers, such as β-CTX and TRACP-5b, were observed (P < 0.05).
Patient-reported outcomes also significantly improved with the combination treatment (P < 0.05).

Abstract

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

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