Introduction: We aimed to compare annual changes in the bone mineral
density (BMD) at the lumbar spine (LS) and the femoral neck (FN) in
males with HIV-associated osteoporosis treated with either zoledronate
(ZOL) or denosumab (Dmab).
Methods: In this open label, 12-month, prospective, multicenter, cohort
study, 23 male people living with HIV (PLWH) under antiretroviral
therapy (ART) with low BMD were administered either a single iv infusion
of ZOL 5 mg (n = 10) or Dmab 60 mg sc injections biannually (n = 13).
Fourteen age-matched male PLWH with normal BMD served as controls. BMD
was measured at baseline and at 12 months.
Results: LS-BMD increased within both treatment groups at 12 months (ZOL
5.43% +/- 3.60%, p = 0.001; Dmab 5.76% +/- 3.44%, p < 0.005) and
decreased in controls ( 2.58% +/- 4.12, p = 0.04). FN-BMD increased in
both treatment groups at 12 months (ZOL 7.23% +/- 5.46%, p = 0.003;
Dmab 3.01% +/- 2.46%, p < 0.005), and remained unchanged in controls
(1.22% +/- 2.09, p = 0.06). LS-BMD changes did not differ between the
two treatment groups, but FN-BMD changes were more prominent in the ZOL
group (p < 0.05). None of our study cohort sustained new fragility
fractures during the 12-month study period, and no case of acute phase
response was recorded in the ZOL group.
Conclusions: In male PLWH under ART requiring osteoporosis treatment
both ZOL and Dmab are efficient and well tolerated therapeutic options
achieving BMD increases at least for the first year of treatment