Denosumab versus zoledronate for the treatment of low bone mineral density in male HIV-infected patients

Makras, Polyzois; Petrikkos, Panagiotis; Anastasilakis, Athanasios D.; Kolynou, Artemis; Κατσαρού, Αλεξάνδρα; Tsachouridou, Οlga; Metallidis, Symeon; Yavropoulou, Maria P

doi:10.1016/j.bonr.2021.101128

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…Our increase in the lumbar spine was at a similar percentage to that expected from the ADAMO study (around 5.7%) while the annual femur neck BMD increase was somewhat higher than that from the ADAMO study (around 2.1%) [ 17 ]. Plus, our data were quite similar to the increases in BMD observed in Smith et al [ 18 ], which involved prostate cancer patients with low bone mass or a history of fragility fracture, receiving androgen deprivation therapy (HALT trial) and those in Makras et al [ 19 ], which evaluated the effect of denosumab in male HIV-infected patients (5.8% in the lumbar spine and 3.0% in the femoral neck). The same results were shown regarding BTM.…”

Section: Discussionsupporting

confidence: 88%

The efficacy of denosumab in Korean male patients with osteoporosis

Jeong¹,

Ha²,

Kim³

et al. 2022

Korean J Intern Med

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Background/Aims: Despite the prominence of denosumab as the number one prescribed anti-osteoporosis drug in Korea, the effects of denosumab in male osteoporosis patients were not researched sufficiently. Moreover, concerns on rebound vertebral fractures associated with poor denosumab adherence exist.Methods: We retrospectively evaluated 147 Korean male osteoporosis patients treated with denosumab. After 12 months of treatment, 60 patients were lost during follow-up, and eight were excluded due to missing data. Out of the initial 147 patients, 79 were considered eligible for the analysis of the efficacy of denosumab. 54 patients were initially drug-naïve, and 25 had previously received bisphosphonate therapy.Results: In 54 drug-naïve patients, significant increases in bone mineral density (BMD) were observed in all measurement sites: 5.2% ± 3.7% in the lumbar spine, 2.3% ± 2.8% in the femoral neck, and 1.9% ± 2.8% in the total hip (p < 0.01, respectively). Trabecular bone score showed an increase of 0.5% ± 5.8% in drug-naïve patients. Likewise, in 25 patients with previous bisphosphonate treatment, increase in BMD were observed as well: 4.8% ± 3.5% in the lumbar spine, 1.4% ± 3.6% in the femoral neck, and 0.8% ± 2.1% in the total hip (p < 0.01, p = 0.06, p = 0.06, respectively). Significant declines of –55.1% ± 31.8% in C-terminal telopeptide of type 1 collagen (CTX), and –62.9% ± 21.3% in total procollagen 1 N-terminal propeptide (P1NP), in drug-naïve patients; and –37.7% ± 41.5%, in CTX and –55.4% ± 30.1%, in P1NP in patients with previous bisphosphonate treatment were exhibited after 12 months of treatment. The adherence rates of the second and third dosing schedules were 79.9% and 56.8%, respectively.Conclusions: Our study indicates that denosumab is effective in increasing BMD in Korean osteoporosis males regardless of prior bisphosphonate treatment.

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Section: Discussionsupporting

confidence: 88%

The efficacy of denosumab in Korean male patients with osteoporosis

Jeong¹,

Ha²,

Kim³

et al. 2022

Korean J Intern Med

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“…Alternative treatments like denosumab may be beneficial for certain patients, especially when bisphosphonates are contraindicated or ineffective. A 12-month, open-label, prospective study showed that both denosumab and zoledronate improved BMD in 23 males with HIV, with no significant difference in lumbar spine BMD change or adverse events between the two groups [124].…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Bone Disease in HIV: Need for Early Diagnosis and Prevention

Schinas,

Ntampanlis

et al. 2024

Life

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The transformation of HIV into a manageable chronic condition has unveiled new clinical challenges associated with aging-related pathologies, including bone disease. This review explores the intricate relationship between HIV, antiretroviral therapy (ART), and bone disease, highlighting the necessity of early diagnosis and preventative strategies to mitigate the increased risk of osteopenia, osteoporosis, and fractures in people living with HIV (PLWHIV). It synthesizes the current literature to elucidate the multifactorial etiology of bone pathology in this population, that includes direct viral effects, chronic immune activation, ART-associated risks, and the impact of traditional risk factors for bone loss. Through a critical examination of modern diagnostic methods, lifestyle modifications, evidence-based preventive actions, and pharmacological treatments, the necessity for comprehensive management is highlighted, along with recommendations for integrated healthcare approaches vital for achieving optimal patient outcomes. By advocating for a proactive, patient-centered, and multidisciplinary strategy, this review proposes a plan to integrate bone health into standard HIV care through active risk identification, vigilant screening, effective preventive measures, tailored treatments, and informed decision-making, in an effort to ultimately enhance the quality of life for PLWHIV.

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“…Makras et al showed in a prospective open-label, 12-month-long multicenter cohort study in male PLWHIV being treated for osteoporosis with ARVs, zoledronic acid and denosumab are efficient and well-tolerated therapeutic options for increasing BMD, at least for the first year of treatment. The major weakness of this trial is that it recruited only 23 PLWHIV (zoledronic acid was given to 10 patients, while denosumab was given to 13 as a control) [ 112 ].…”

Section: Anti-osteoporotic Drugsmentioning

confidence: 99%

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

et al. 2023

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The developments in Human Immunodeficiency Virus (HIV) treatment and in the care of people living with HIV (PLWHIV) and Acquired Immunodeficiency Syndrome (AIDS) over the last three decades has led to a significant increase in life expectancy, on par with HIV-negative individuals. Aside from the fact that bone fractures tend to occur 10 years earlier than in HIV-negative individuals, HIV is, per se, an independent risk factor for bone fractures. A few available antiretroviral therapies (ARVs) are also linked with osteoporosis, particularly those involving tenofovir disoproxil fumarate (TDF). HIV and hepatitis C (HCV) coinfection is associated with a greater risk of osteoporosis and fracture than HIV monoinfection. Both the Fracture Risk Assessment Tool (FRAX) and measurement of bone mineral density (BMD) via a DEXA scan are routinely used in the assessment of fracture risk in individuals living with HIV, as bone loss is thought to start between the ages of 40 and 50 years old. The main treatment for established osteoporosis involves bisphosphonates. Supplementation with calcium and vitamin D is part of clinical practice of most HIV centers globally. Further research is needed to assess (i) the cut-off age for assessment of osteoporosis, (ii) the utility of anti-osteoporotic agents in PLWHIV and (iii) how concomitant viral infections and COVID-19 in PLWHIV can increase risk of osteoporosis.

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Denosumab versus zoledronate for the treatment of low bone mineral density in male HIV-infected patients

Cited by 9 publications

References 26 publications

The efficacy of denosumab in Korean male patients with osteoporosis

The efficacy of denosumab in Korean male patients with osteoporosis

Bone Disease in HIV: Need for Early Diagnosis and Prevention

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

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