Dear Editor, We read with interest the recent systematic review and meta-analysis published by Aryana et al.1) entitled “Denosumab's therapeutic effect for future osteosarcopenia therapy: a systematic review and meta-analysis.” The meta-analysis included four studies and concluded that denosumab (a human monoclonal antibody osteoporosis medication) improved hand grip strength (but not lumbar spine bone mineral density or gait speed) to a greater extent than bisphosphonates (another antiresorptive bone medication). We wish to draw attention to several methodological flaws that are likely to have influenced the outcomes and interpretation of this meta-analysis.