Titre
Fractures After Denosumab Discontinuation: A Retrospective Study of 797 Cases.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Burckhardt, P.
Auteure/Auteur
Faouzi, M.
Auteure/Auteur
Buclin, T.
Auteure/Auteur
Lamy, O.
Auteure/Auteur
Groupes de travail
The Swiss Denosumab Study Group
Liens vers les personnes
ISSN
1523-4681
Statut éditorial
Publié
Date de publication
2021-09
Volume
36
Numéro
9
Première page
1717
Dernière page/numéro d’article
1728
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
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).
PID Serval
serval:BIB_3B3FDC4DE2B9
PMID
Open Access
Oui
Date de création
2021-05-25T06:38:09.435Z
Date de création dans IRIS
2025-05-20T17:24:42Z
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Nom
Article_Peter Burckhardt_Fractures After Denosumab Discontinuation_A Retrospective Study of 797 Cases_J Bone Miner Res_2021_jbmr.4335.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by-nc-nd/4.0
Taille
598 KB
Format
Adobe PDF
PID Serval
serval:BIB_3B3FDC4DE2B9.P001
URN
urn:nbn:ch:serval-BIB_3B3FDC4DE2B93
Somme de contrôle
(MD5):68442030349a59694192518bc5946b87