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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2021

01-12-2021 | Bisphosphonate | Original Article

Effects of denosumab on rheumatic diseases and refractory glucocorticoid-induced osteoporosis: a prospective study

Authors: Takaaki Ishida, Shuzo Yoshida, Youhei Fujiki, Kenichiro Hata, Takuya Kotani, Tohru Takeuchi

Published in: Archives of Osteoporosis | Issue 1/2021

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Abstract

Summary

This study evaluates the clinical efficacy of denosumab for glucocorticoid-induced osteoporosis (GIOP) refractory to previous osteoporosis treatment. Our results show that denosumab significantly increased BMD of the lumbar spine and bilateral hip over the 24-month study period. Denosumab demonstrates potential as a treatment for GIOP refractory to previous therapy.

Introduction

The aim of this study was to evaluate the clinical efficacy and safety of denosumab in patients with rheumatic diseases and glucocorticoid-induced osteoporosis (GIOP) refractory to previous osteoporosis treatment.

Methods

All patients were treated with 60 mg of denosumab subcutaneously every 6 months for 2 years after administration of bisphosphonates or rhPTH was stopped. We assessed bone mineral density (BMD) of the lumbar spine and bilateral hip at baseline, and at 6, 12, 18, and 24 months. We measured serum levels of bone alkaline acid phosphatase (BAP) and tartrate-resistant acid phosphatase (TRACP)-5b at baseline, and at 3, 6, 12, 18, and 24 months.

Results

Fifty-five patients with rheumatic diseases and GIOP were enrolled in this study. All patients were treated with bisphosphonates (n=40), recombinant human parathyroid hormone (n=4), or active vitamin D3 (n=11). Over the 24-month study period, denosumab significantly increased the mean BMD of the lumbar spine and bilateral hip (5.8 ± 0.7%, and 1.3 ± 0.4%, respectively). Additionally, denosumab also significantly reduced the serum levels of TRACP-5b and BAP over this same period (by −38.8 ± 3.5% and −16.3 ± 3.1%, respectively), although these changes in bone turnover markers were not predictive factors of an improvement in BMD values. While three patients developed fragility fractures during the study period, all three had several risk factors for fragility fractures in GIOP.

Conclusions

In conclusion, denosumab is a potential treatment for GIOP in rheumatic diseases, especially in patients refractory to previous therapy, including bisphosphonate therapy.
Appendix
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Metadata
Title
Effects of denosumab on rheumatic diseases and refractory glucocorticoid-induced osteoporosis: a prospective study
Authors
Takaaki Ishida
Shuzo Yoshida
Youhei Fujiki
Kenichiro Hata
Takuya Kotani
Tohru Takeuchi
Publication date
01-12-2021
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2021
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-021-00899-5

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