Osteoporosis Therapy With Denosumab in Organ Transplant Recipients

• Published in: Frontiers in endocrinology (Lausanne) 2018-04, Vol.9, p.162-162
• Main Authors: Brunova, Jana, Kratochvilova, Simona, Stepankova, Jitka
• Format: Article
• Language: English
• Subjects: denosumab; dual energy X-ray absorptiometry; Endocrinology; monoclonal antibody; osteoporosis; solid organ transplantation
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2018.00162

Osteoporosis and fragility fractures represent serious complications for the solid organ transplant population. The recommended osteoporosis therapy for organ recipients involves supplementation with calcium and vitamin D and bisphosphonate administration. However, these options can prove limited for patients with impaired renal function. An alternative therapy option is offered by denosumab, a monoclonal antibody that targets receptor activator of nuclear factor kappa-B ligand. We evaluated 63 patients with osteoporosis (23 males and 40 females, age 56.4 ± 13.1 years) following solid organ transplantation (15 diabetic patients after simultaneous transplantation of the kidney and pancreas, 34 patients after kidney transplantation, and 14 patients with liver grafts). Osteoporosis was diagnosed according to standard DEXA examination using the Lunar Prodigy apparatus. Transplanted patients with impaired renal function were treated for osteoporosis of the lumbar spine (L-spine) and/or proximal femur with calcium and vitamin D supplementation and 60 mg of denosumab every 6 months between the years 2012 and 2017. The mean duration of the therapy was 1.65 ± 0.7 years. After denosumab therapy, L-spine -scores improved across the whole group, ranging from -2.7 ± 0.09 to -1.8 ± 1.0 (