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Fractures After Denosumab Discontinuation: A Retrospective Study of 797 Cases

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Název: Fractures After Denosumab Discontinuation: A Retrospective Study of 797 Cases
Autoři: Peter Burckhardt, Mohamed Faouzi, Thierry Buclin, Olivier Lamy
Přispěvatelé: The Swiss Denosumab Study Group
Zdroj: J Bone Miner Res
Journal of bone and mineral research, vol. 36, no. 9, pp. 1717-1728
Informace o vydavateli: Oxford University Press (OUP), 2020.
Rok vydání: 2020
Témata: Fractures, Bone, 03 medical and health sciences, 0302 clinical medicine, Bone Density Conservation Agents, Diphosphonates, Bone Density, Humans, Original Articles, Denosumab/adverse effects, Diphosphonates/adverse effects, Retrospective Studies, ANTIRESORPTIVES, DENOSUMAB, FRACTURE RISK ASSESSMENT, OSTEOPOROSIS, STATISTICAL METHODS, Denosumab, 3. Good health
Popis: A rebound of osteoclast activity during the 2 years after a treatment or prevention of osteoporosis with denosumab (Dmab) leads to an increased risk of vertebral fractures (VFs). We attempted to identify the risk factors for these VF and to examine the protective role of bisphosphonates. For that, 22 specialists in Switzerland provided data of unselected patients, treated with denosumab for osteoporosis or breast cancer without metastases under aromatase inhibitors, who have received at least two injections of Dmab, with at least 1 year of follow-up after discontinuation. The questionnaire covered separately the periods before, during, and after Dmab treatment, and registered clinical, radiological, and lab data. For the analysis of the risk factors, the main outcomes were the time to the first VF after the treatment, the presence of multiple VFs (MVFs), and the number of VFs. The incidence of VF was 16.4% before, 2.2% during, and 10.3% after the treatment with Dmab. The risk of VF after Dmab discontinuation was associated with an increased risk of non-vertebral fractures. The pretreatment predictors of the post-treatment fracture risk were a parental hip fracture and previous VFs. Further risk factors appeared later, such as low total hip bone mineral density (BMD) during and after denosumab, increased bone resorption markers, and the loss of total hip BMD after the denosumab. Treatment with bisphosphonates, especially after Dmab, had a protective effect. Bisphosphonates given before Dmab did not further decrease the risk of VF in cases who got bisphosphonates after Dmab. This study shows that the risk of VF is poorly predictable before the prescription of denosumab. But during and after the treatment, bone resorption markers and BMD have a significant predictive value. Bisphosphonates after the treatment with denosumab are protective against VFs. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Druh dokumentu: Article
Other literature type
Popis souboru: application/pdf
Jazyk: English
ISSN: 1523-4681
0884-0431
DOI: 10.1002/jbmr.4335
Přístupová URL adresa: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jbmr.4335
https://pubmed.ncbi.nlm.nih.gov/34009703
https://pubmed.ncbi.nlm.nih.gov/34009703/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518625/
https://asbmr.onlinelibrary.wiley.com/doi/full/10.1002/jbmr.4335
https://europepmc.org/article/MED/34009703
https://serval.unil.ch/notice/serval:BIB_3B3FDC4DE2B9
https://serval.unil.ch/resource/serval:BIB_3B3FDC4DE2B9.P001/REF.pdf
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_3B3FDC4DE2B93
Rights: CC BY NC ND
URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Přístupové číslo: edsair.doi.dedup.....b6dcdece868603b97444003667d8cfb5
Databáze: OpenAIRE
Popis
Abstrakt:A rebound of osteoclast activity during the 2 years after a treatment or prevention of osteoporosis with denosumab (Dmab) leads to an increased risk of vertebral fractures (VFs). We attempted to identify the risk factors for these VF and to examine the protective role of bisphosphonates. For that, 22 specialists in Switzerland provided data of unselected patients, treated with denosumab for osteoporosis or breast cancer without metastases under aromatase inhibitors, who have received at least two injections of Dmab, with at least 1 year of follow-up after discontinuation. The questionnaire covered separately the periods before, during, and after Dmab treatment, and registered clinical, radiological, and lab data. For the analysis of the risk factors, the main outcomes were the time to the first VF after the treatment, the presence of multiple VFs (MVFs), and the number of VFs. The incidence of VF was 16.4% before, 2.2% during, and 10.3% after the treatment with Dmab. The risk of VF after Dmab discontinuation was associated with an increased risk of non-vertebral fractures. The pretreatment predictors of the post-treatment fracture risk were a parental hip fracture and previous VFs. Further risk factors appeared later, such as low total hip bone mineral density (BMD) during and after denosumab, increased bone resorption markers, and the loss of total hip BMD after the denosumab. Treatment with bisphosphonates, especially after Dmab, had a protective effect. Bisphosphonates given before Dmab did not further decrease the risk of VF in cases who got bisphosphonates after Dmab. This study shows that the risk of VF is poorly predictable before the prescription of denosumab. But during and after the treatment, bone resorption markers and BMD have a significant predictive value. Bisphosphonates after the treatment with denosumab are protective against VFs. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
ISSN:15234681
08840431
DOI:10.1002/jbmr.4335