A Single Infusion of Zoledronate in Postmenopausal Women Following Denosumab Discontinuation Results in Partial Conservation of Bone Mass Gains

ABSTRACT Discontinuation of denosumab is associated with a rapid return of bone mineral density (BMD) to baseline and an increased risk of multiple vertebral fractures. No subsequent treatment regimen has yet been established for preventing either loss of BMD or multiple vertebral fractures after de...

Full description

Saved in:
Bibliographic Details
Published in:Journal of bone and mineral research 2020-07, Vol.35 (7), p.1207-1215
Main Authors: Everts‐Graber, Judith, Reichenbach, Stephan, Ziswiler, Hans Rudolf, Studer, Ueli, Lehmann, Thomas
Format: Article
Language:English
Subjects:
Bone loss
Bone mass
Bone mineral density
DENOSUMAB
DISCONTINUATION
Dual energy X-ray absorptiometry
FRACTURE
Fractures
Immunotherapy
Injection
Monoclonal antibodies
OSTEOPOROSIS
Patients
Post-menopause
Spine (lumbar)
Vertebrae
ZOLEDRONATE
Zoledronic acid
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT Discontinuation of denosumab is associated with a rapid return of bone mineral density (BMD) to baseline and an increased risk of multiple vertebral fractures. No subsequent treatment regimen has yet been established for preventing either loss of BMD or multiple vertebral fractures after denosumab discontinuation. The aim of this 8‐year observational study was to investigate the effect of a single zoledronate infusion, administered 6 months after the last denosumab injection, on fracture occurrence and loss of BMD. We report on 120 women with postmenopausal osteoporosis who were treated with 60 mg denosumab every 6 months for 2 to 5 years (mean duration 3 years) and then 5 mg zoledronate 6 months after the last denosumab injection. All patients were evaluated clinically, by dual‐energy X‐ray absorptiometry (DXA) and vertebral fracture assessment (VFA), before the first and after the last denosumab injection and at 2.5 years (median) after denosumab discontinuation. During this off‐treatment period, 3 vertebral fractures (1.1 per 100 patient‐years) and 4 nonvertebral fractures (1.5 per 100 patient‐years) occurred. No patients developed multiple vertebral fractures. Sixty‐six percent (confidence interval [CI] 57% to 75%) of BMD gained with denosumab was retained at the lumbar spine and 49% (CI 31% to 67%) at the total hip. There was no significant difference in the decrease of BMD between patients with BMD gains of >9% versus
ISSN:0884-0431
1523-4681
DOI:10.1002/jbmr.3962