Impact of denosumab on fracture healing in osteoporotic patients: A double-blind, randomized trial

Background: Osteoporosis delays fracture healing due to impaired bone remodeling. Denosumab, a monoclonal antibody targeting RANKL, reduces fracture risk but its role in healing is underexplored. Aim and Objectives: To evaluate the effect of denosumab on fracture healing in osteoporotic patients compared to standard care. Material and Methods: This was a randomized controlled trial of 60 patients (aged 50-85 years) with osteoporotic fractures. The intervention group received 60 mg denosumab with calcium and vitamin D3, while the control group received calcium and vitamin D3 alone. Healing was assessed radiologically and clinically at 6 weeks, 3 months, and 6 months post-operatively. Results: At 3 months, 73.33% of denosumab-treated patients had healed fractures versus 26.67% in the control group (p<0.0001). By 6 months, healing rates were similar. No significant differences were found in serum calcium, vitamin D3 levels, or fracture site distribution. Conclusion: Denosumab accelerates early fracture healing in osteoporotic patients, supporting its use as an adjunct therapy.