Efficacy of Denosumab Therapy Following Treatment with Bisphosphonates in Women with Osteoporosis: A Cohort Study

Denosumab is a human monoclonal antibody that neutralizes RANKL, a cytokine able to interact with the RANK receptor on preosteoclasts and osteoclasts, decreasing their recruitment and differentiation, leading to a decreased bone resorption. The aim of this observational real-life study was to analyze adherence to denosumab therapy and assess its efficacy in increasing bone mineral density (BMD) and modulating biochemical skeletal markers following previous treatments with bisphosphonates in a group of post-menopausal women with osteoporosis. Women were recruited in the specialized center from March 2012 to September 2019. Biochemical markers were recorded at baseline and every six months prior to subsequent drug injection. Dual X-ray absorptiometry was requested at baseline and after 18/24 months. Comparing BMD at baseline and after denosumab therapy in naive patients and in those previously treated with bisphosphonates, a positive therapeutic effect was observed in both groups. The results of our real-life study demonstrate, as expected, that BMD values significantly increased upon denosumab treatment. Interestingly, denosumab showed an increased efficacy in patients previously treated with bisphosphonates. Moreover, biochemical markers data indicate that osteoporotic patients, without other concomitant unstable health conditions, could be evaluated once a year, decreasing the number of specialistic center access.

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Effectiveness of Denosumab Therapy after Treatment with Bisphosphonates in Women Affected by Osteoporosis: A Real-Life Study

10.20944/preprints202012.0498.v1 ◽

2020 ◽

Author(s):

Chiara Marocco ◽

Giovanna Zimatore ◽

Edoardo Mocini ◽

Rachele Fornari ◽

Giovanni Iolascon ◽

...

Keyword(s):

Biochemical Markers ◽

Human Monoclonal Antibody ◽

Real Life ◽

Mineral Density ◽

Life Study ◽

Positive Therapeutic Effect ◽

Specialized Center ◽

Previously Treated ◽

Real Life Study ◽

Post Menopausal

Denosumab is a human monoclonal antibody that neutralizes RANKL, a cytokine able to interact with the RANK receptor on preosteoclasts and osteoclasts, decreasing their recruitment and differentiation, leading to a decreased bone resorption. The aim of this observational real-life study was to analyze adherence to denosumab therapy, its effectiveness in increasing bone mineral density (BMD) and in modulating biochemical skeletal markers upon previous treatments with bisphosphonates in a group of post-menopausal women affected by osteoporosis. Women were recruited in the specialized center from March 2012 to September 2019. Biochemical markers were recorded at baseline and every six months prior to subsequent drug injection. Dual X-ray Absorptiometry was requested at baseline and after 18/24 months. Comparing BMD at baseline and after denosumab therapy in naive patients and in those previously treated with bisphosphonates, a positive therapeutic effect was observed in both groups. The results of our real-life study demonstrate, as expected, that BMD values significantly increased upon denosumab treatment. Interestingly, denosumab showed an increased effectiveness in patients previously treated with bisphosphonates. Moreover, biochemical markers data indicate that osteoporotic patients, without other concomitant unstable health conditions, could be evaluated once a year, decreasing the number of specialistic center access.

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A real life study of Helicobacter pylori eradication with bismuth quadruple therapy in naïve and previously treated patients

Revista Española de Enfermedades Digestivas ◽

10.17235/reed.2017.4809/2016 ◽

2017 ◽

Vol 109 ◽

Cited By ~ 8

Author(s):

Blas José Gómez Rodríguez ◽

Luisa Castro Laria ◽

Federico Argüelles Arias ◽

Cristina Castro Márquez ◽

Ángel Caunedo Álvarez ◽

...

Keyword(s):

Helicobacter Pylori ◽

Real Life ◽

Helicobacter Pylori Eradication ◽

Quadruple Therapy ◽

Life Study ◽

Previously Treated Patients ◽

Previously Treated ◽

Real Life Study

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The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study

Journal of Endocrinological Investigation ◽

10.1007/s40618-019-01131-5 ◽

2019 ◽

Vol 43 (4) ◽

pp. 469-475 ◽

Cited By ~ 2

Author(s):

T. R. Fraser ◽

I. Flogaitis ◽

A. E. Moore ◽

G. Hampson

Keyword(s):

Real Life ◽

Previous Treatment ◽

Bisphosphonate Therapy ◽

Bisphosphonate Treatment ◽

Mineral Density ◽

Life Study ◽

Group A ◽

Real Life Study ◽

Group B ◽

The Impact

Abstract Purpose To investigate changes in bone mineral density (BMD) following denosumab after previous bisphosphonate therapy and the impact of chronic kidney disease (CKD) on response. Methods A retrospective study of 134 patients (11 M, 123 F) aged [mean (SD)] 72 [11] years on denosumab was undertaken. Ninety-five patients had previously been on oral and 28 on iv bisphosphonate. Lumbar spine (LS), total hip (TH) and femoral neck (FN) BMD were measured before treatment and at 2.7 [1.2] years. GFR was < 35 ml/min in 24 patients (18%). Ninety-four (18 M, 76 F) patients aged 71 [11] years transitioning to zoledronate were also studied. Results BMD improved following denosumab [mean (SEM) % change LS: 6.0 (0.62) p < 0.001, TH: 2.28 (0.64) p < 0.001, FN: 1.9 (0.77) p = 0.045]. Changes at the TH and FN were lower in patients with GFR < 35 ml/min (Group B) compared to those with GFR > 35 ml/min (Group A) [% change TH; Group A: 2.9 (0.72), Group B: − 0.84 (1.28), p = 0.015, FN; Group A: 2.76 (0.86), Group B: − 1.47 (1.53), p = 0.025]. % change in BMD at the FN and PTH were negatively associated (r = − 0.25, p = 0.013). BMD changes were not different at 12–18 months between patients on denosumab compared to zoledronate [% change at LS: denosumab: 3.97% (0.85), zoledronate: 2.6% (0.5), p = 0.19 TH: denosumab: 0.97% (0.58), zoledronate: 0.92% (0.6), p = 0.95). Conclusion Denosumab increases BMD following previous bisphosphonate treatment and is comparable to zoledronate. Lower response seen at the hip in CKD is related to PTH concentrations.

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