Efficacy of Antiosteoporotic Medications in Patients With Rebound-Associated Fractures After Denosumab Discontinuation |
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| Institution: | 1. Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece;2. First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece;3. Department of Endocrinology and Diabetes and Department of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece;4. Laboratory for the Research of Musculoskeletal System “Th. Garofalidis”, Medical School, National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece;5. Endocrinology Unit, 1st Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;1. Department of Industrial Engineering, Tsinghua University, Beijing, China;2. Nuffield Department of Medicine, University of Oxford, Oxford, UK;3. School of Engineering, National University of Ireland, Galway, Ireland;4. School of Computer Science, National University of Ireland, Galway, Ireland;5. Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taiwan;6. School of Medicine, National University of Ireland, Galway, Ireland;7. Department of Rheumatology, Our Lady''s Hospital, Manorhamilton, Co. Leitrim, Ireland;8. Department of Geriatric Medicine, Sligo University Hospital, Sligo, Ireland;9. Department of Rheumatology, Galway University Hospitals, Galway, Ireland;1. Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;2. Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;3. Department of Endocrinology, Key Laboratory of Endocrinology, The National Commission of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;4. Tsinghua University Medical College, Beijing, China;5. Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA;1. Specialist Trainee in Endocrinology, Royal Glamorgan Hospital, Cwm Taf Morgannwg University Health Board, Llantrisant, United Kingdom;2. Consultant in Rheumatology, Royal Glamorgan Hospital, Cwm Taf Morgannwg University Health Board, Llantrisant, United Kingdom;3. Consultant in Endocrinology, Prince Charles Hospital, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, United Kingdom;1. Department of Endocrinology and Diabetes, Alfred Health, Victoria, Australia;2. Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia;3. Department of Respiratory Medicine, Alfred Health, Victoria, Australia;4. School of Public Health and Preventive Medicine, Monash University, Victoria, Australia;1. Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon;2. Laboratoire Mouvement, Equilibre, Performance et Santé (EA 4445), Département STAPS, Université de Pau et des Pays de l''Adour, Tarbes, France |
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| Abstract: | Denosumab discontinuation results in rapid bone loss and increased risk of multiple rebound-associated vertebral fractures (RAVFs). The optimal treatment for patients who have sustained such fractures is currently unknown. We aimed to investigate the bone mineral density (BMD) changes achieved with various regimens in postmenopausal women who had sustained RAVFs after denosumab discontinuation in everyday clinical practice. In this multicenter, retrospective observational study, 39 Greek postmenopausal women from six regional bone centers throughout Greece with RAVFs after denosumab discontinuation were included. We collected BMD and fracture data before and 1 year after treatment with denosumab (n = 20), teriparatide (n = 8), zoledronate (n = 8) or teriparatide/denosumab combination (n = 3). Both lumbar spine (LS)-- and femoral neck (FN)-BMD were preserved with all regimens used. With the exception of zoledronate, a trend towards increase was observed with all regimens in LS-BMD. Three patients sustained additional fractures despite treatment reinstitution (2 with zoledronate and 1 with teriparatide). Among patients with RAVFs following denosumab discontinuation both antiresorptive (zoledronate and denosumab) and anabolic (teriparatide) treatment as well as the combination of denosumab with teriparatide seem to be effective in terms of BMD response. |
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