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Denosumab is Associated with Improved Liver Function and Reduced Fibrosis Scores in Patients with Metabolic Dysfunction-associated Steatotic Liver Disease and Osteoporosis: A Retrospective Observational Study

Endocr Metab Immune Disord Drug Targets. 2026 Jul 2. doi: 10.2174/0118715303434247251208072607. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate the effects of denosumab and alendronate on bone mineral density (BMD) and liver fibrosis markers in patients with both primary osteoporosis (OP) and metabolic dysfunction-associated steatotic liver disease (MASLD).

METHODS: This was a single-center, retrospective observational study. A total of 60 patients diagnosed with both OP and MASLD were identified from Zhejiang Hospital and categorized into two groups based on their actual treatment received: denosumab (n=30) or alendronate (n=30). Baseline data, including demographic information, clinical characteristics, BMD, and liver fibrosis markers, were obtained from medical records. These measures were again obtained from records after approximately one year of treatment to evaluate changes in BMD and liver fibrosis markers.

RESULTS: In the denosumab group, marked improvements in BMD were observed at the lumbar spine (L1-4), femoral neck, and total hip (all P < 0.01). Additionally, there were notable reductions in liver fibrosis markers, such as FIB-4 and NFS (P < 0.01 and P < 0.05, respectively). In the alendronate group, only an increase in lumbar spine (L1-4) BMD was noted (P < 0.05), with no statistically significant changes observed in femoral neck or total hip BMD (P > 0.05), nor in liver fibrosis markers.

CONCLUSION: Denosumab use was associated with improvements in BMD and reductions in liver fibrosis in patients with OP and MASLD, suggesting it may be a promising therapeutic option.

PMID:42405391 | DOI:10.2174/0118715303434247251208072607

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