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A randomised Phase 3 study comparing the efficacy and safety of proposed denosumab biosimilar RGB-14-P and reference denosumab in women with postmenopausal osteoporosis

Seefried L, Ferrari S, Páll D, Viapiana O, Rosa J, Supronik J, Licheva RN, Kiefer J et al.

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025

473 participants · 2 citations

Abstract

• In women with postmenopausal osteoporosis, proposed denosumab biosimilar RGB-14-P demonstrated equivalent efficacy and pharmacodynamics, and similar immunogenicity and safety to reference denosumab. • RGB-14-P comprehensively replicates the therapeutic benefit of denosumab in a clinical setting. • Denosumab biosimilars, such as RGB-14, have potential to provide lower-cost alternatives to denosumab with comparable efficacy and safety.

Purpose: To demonstrate the equivalence of the proposed denosumab biosimilar RGB-14-P and the reference denosumab (hereafter denosumab) in women with postmenopausal osteoporosis.

Methods: In this multicentre, double-blind, Phase 3 study (EudraCT 2020-006017-38; NCT05087030), participants were randomised 1:1 to subcutaneous RGB-14-P or denosumab 60 mg every 6 months, on Day 1 and Week 26, with follow-up to Week 52. Primary endpoints were percentage change from baseline (%CfB) in lumbar spine bone mineral density (BMD) at Week 52 and area under the effective curve (AUEC) of %CfB serum C-terminal telopeptide of type 1 collagen (CTX) to Week 26. Secondary endpoints included %CfB in total hip and femoral neck BMD, vertebral and non-vertebral fragility fractures, immunogenicity, and safety to Week 52.

Results: Overall, 473 participants were randomised and received study drug (RGB-14-P, n = 242; denosumab, n = 231). Both primary endpoints demonstrated equivalence of RGB-14-P and denosumab. Adjusted mean (95% CI) %CfB in lumbar spine BMD at Week 52…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 473 participants or records.

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