Effect of Denosumab on Bone Mineral Density and Markers of Bone Turnover among Postmenopausal Women with Osteoporosis

Abstract

The aim of this study was to evaluate the effect of denosumab (Dmab) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of Dmab in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 425 postmenopausal women treated with Dmab for 1 year in clinical practice conditions in specialized centers from Argentina. Participants were also divided according to previous bisphosphonate treatment into BP-naïve and BP-prior. A control group of patients treated with BP not switched to Dmab matched by sex, age, and body mass index was used. Data are expressed as mean ± SEM. After 1 year of treatment with Dmab the bone formation markers total alkaline phosphatase and osteocalcin were significantly decreased (23.36% and 43.97%, resp.), as was the bone resorption marker s-CTX (69.61%). Significant increases in BMD were observed at the lumbar spine, femoral neck, and total hip without differences between BP-naïve and BP-prior. A better BMD response was found in BP-prior group compared with BP treated patients not switched to Dmab. Conclusion. Dmab treatment increased BMD and decreased bone turnover markers in the whole group, with similar response in BP-naïve and BP-prior patients. A better BMD response in BP-prior patients versus BP treated patients not switched to Dmab was observed.

THERAPY OF ENDOCRINE DISEASE: Denosumab vs bisphosphonates for the treatment of postmenopausal osteoporosis

“…RCTs investigating the efficacy of Dmab in women previously on BPs are summarized in Table 2. It is of interest that Dmab administration results in similarly suppressed BTMs, despite the lower baseline levels in patients pretreated with BPs compared to treatment-naïve patients (54,84,85). BMD increases with Dmab were similar between responders and non-responders to previous BP treatment (84).…”

Association of Young Age with Bone Mineral Density Improvement with Denosumab Treatment in Patients with Osteoporosis

“…Sanchez et al reported that a better response was observed in denosumab-treated group previously treated with bisphosphonate compared with the nonpretreated group and concluded that the discrepancy of the result could be attributed to the small number of the control group [20]. Bisphosphonates could also reduce bone resorption; however, the mechanism of action is different from that of denosumab.…”

Impact of Monthly 120 Mg Denosumab on Bone Metabolism in Bone-metastatic Prostate Cancer Undergoing Androgen Deprivation Therapy

“…There have been a lot of studies which investigated the effect of semiannual 60 mg denosumab on BMD in both normal populations [22][23][24][25][26][27] and PC patients treated with ADT [28,29]. In low BMD postmenopausal women, semiannual 60 mg denosumab has reportedly increased BMD at lumbar spine by 4.6-5.2% and that at femoral neck by 2.1-3.5% after a year of initiation [22,23]. In the same setting, it has also been reported to increase BMD at lumbar spine by around 6.5% and that at femoral neck by 2.8% after two years of initiation [24,25].…”

“…Notably, it has also been reported to improve bone metastasis-free survival in non-metastatic castration-resistant PC [20,21]. On the other hand, it is also a common treatment for osteoporosis when used in a different dosage: semiannual 60 mg denosumab has been shown to increase bone mineral density (BMD) and affect bone turnover markers in both normal populations [22][23][24][25][26][27] and PC patients treated with ADT [28][29][30]. However, no study has investigated the impact of monthly 120 mg denosumab on bone metabolism to date.…”