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- Title
The Duration of Denosumab Treatment and the Efficacy of Zoledronate to Preserve Bone Mineral Density After Its Discontinuation.
- Authors
Makras, Polyzois; Appelman-Dijkstra, Natasha M.; Papapoulos, Socrates E.; van Wissen, Sandra; Winter, Elizabeth M.; Polyzos, Stergios A.; Yavropoulou, Maria P.; Anastasilakis, Athanasios D.
- Abstract
Context: Zoledronate is used to prevent bone loss following denosumab discontinuation but its efficacy differs among studies. Objective: To test if the duration of denosumab treatment affects the efficacy of subsequent zoledronate infusion. Methods: This multicenter, prospective cohort study, conducted at 2 Greek and 1 Dutch bone centers, included 47 postmenopausal women (n = 47) who received a single zoledronate infusion 6 months after the last denosumab injection and then were followed for 1 year. Twenty-seven women received = 6 denosumab injections (= 6 Group) and 20 received > 6 denosumab injections (> 6 Group). The main outcome measure was changes in lumbar spine (LS) bone mineral density (BMD). Results: At 12 months LS-BMD values were maintained in the = 6 Group (0.98 ± 0.10 to 0.99 ± 0.9 g/cm2, P = 0.409) but decreased significantly in the > 6 Group (1.0 ± 0.11 to 0.93 ± 0.12 g/cm2, P < 0.001). The percent change of LS-BMD of the = 6 Group (+1.0%) was significantly different (P < 0.001) from the change of the > 6 Group (-7.0%). In the whole cohort, the duration of denosumab treatment was negatively correlated with the percentage change of LS-BMD (rs = -0.669, P < 0.001) but not with the change of femoral neck (FN)-BMD. Bone turnover markers increased in all patients 6 months following zoledronate administration with no difference between the 2 groups. Conclusion: The duration of denosumab treatment significantly affects the efficacy of subsequent zoledronate infusion to maintain BMD gains. Frequent follow-up of patients treated with denosumab longer than 3 years is advisable as additional therapeutic interventions may be needed.
- Subjects
DENOSUMAB; ZOLEDRONIC acid; BONE density
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 10, pe4155
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/clinem/dgab321