Effects of denosumab treatment on bone mineral density and joint destruction in patients with rheumatoid arthritis

Mochizuki, Takeshi; Yano, Koichiro; Ikari, Katsunori; Kawakami, Kosei; Hiroshima, Ryo; Koenuma, Naoko; Ishibashi, Mina; Momohara, Shigeki

doi:10.1007/s00774-017-0848-1

Cited by 23 publications

(14 citation statements)

References 23 publications

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“… 14 Among OP drugs, denosumab is considered a good treatment option in OP patients with RA owing to gains in bone turnover markers and BMD 3 , 6 although there is a consensus that denosumab does not suppress RA activity. 15 , 16 …”

Section: Discussionmentioning

confidence: 99%

Effects of denosumab on bone metabolism and bone mineral density with anti-TNF inhibitors, tocilizumab, or abatacept in osteoporosis with rheumatoid arthritis

Suzuki¹,

Nakamura²,

Kato³

2018

TCRM

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IntroductionThe aim of this 18-month retrospective study was to evaluate the differences in outcomes of denosumab with tumor necrosis factor (TNF) inhibitors (TNFis), tocilizumab (TCZ), or abatacept (ABT) treatment in osteoporosis (OP) patients with rheumatoid arthritis (RA).Patients and methodsPatients were divided into TNFis-treated (TNF group; 44 cases), TCZ-treated (TCZ group; 8 cases), or ABT-treated (ABT group; 14 cases) groups. We measured serum bone-specific alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase 5b (TRACP-5b) at baseline and every 3 months for 18 months and assessed bone mineral density (BMD) of the lumbar 1–4 vertebrae (L-BMD) and total hip BMD (H-BMD) at baseline and every 6 months for 18 months.ResultsThere were no significant differences in the percent changes in BAP, TRACP-5b, or L-BMD among the groups. The percent change in H-BMD was significantly increased in the TCZ group at 12 months or at 12 and 18 months, compared with that in the ABT group or TNF group, respectively. The percent change in L-BMD was significantly increased at 12 months in the TCZ and TNF groups, and at 18 months in all the 3 groups compared with pretreatment levels, whereas the percent change in H-BMD was significantly higher at 6, 12, and 18 months in the TCZ group, at 12 and 18 months in the TNF group, and at 18 months in the ABT group, compared with pretreatment levels.ConclusionOur findings suggest that TCZ might be more useful than TNF or ABT in light of the observed H-BMD increases with denosumab therapy for OP patients with RA.

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Section: Discussionmentioning

confidence: 99%

Effects of denosumab on bone metabolism and bone mineral density with anti-TNF inhibitors, tocilizumab, or abatacept in osteoporosis with rheumatoid arthritis

Suzuki¹,

Nakamura²,

Kato³

2018

TCRM

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“…However, it is possible that the number of cases of MRONJ due to denosumab will increase with the expanded use. In 2017, denosumab was approved for the treatment of bone erosion from rheumatoid arthritis 16,17. Furthermore, denosumab has greater preventive effects against skeletal-related events, but leads to almost the same frequency of MRONJ as zoledronate (2.0%, denosumab; 1.4%, zoledronate) 18.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of medication-related osteonecrosis of the jaw using the Japanese Adverse Drug Event Report database

Inada¹,

Hosohata²,

Oyama³

et al. 2018

TCRM

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BackgroundBisphosphonates (BPs) and denosumab are widely used to treat osteoporosis and complications associated with bone metastases. However, medication-related osteonecrosis of the jaw (MRONJ) is a serious problem.ObjectiveThe objective of this study was to evaluate the frequency, outcome, and characteristics of patients with drug-induced MRONJ.MethodsRetrospective pharmacovigilance disproportionality analysis was conducted using the Japanese Adverse Drug Event Report (JADER) database from the Pharmaceuticals and Medical Devices Agency. Adverse event reports submitted to JADER between 2004 and 2017 were analyzed, and the reporting odds ratio (ROR) was calculated.ResultsAmong the BPs that cause MRONJ, zoledronate was the most common; therefore, we compared the characteristics of cases of MRONJ induced by zoledronate with those induced by denosumab. Among the 3,875 (68.1% women) cases of MRONJ, zoledronate-related MRONJ accounted for 1,283 (56.0% women) and denosumab-related MRONJ accounted for 322 (55.3% women). MRONJ was more frequent after 70 years of age regardless of the use of either zoledronate or denosumab; onset occurred after 1 year from the denosumab treatment, but it is unknown when onset occurred after zoledronate treatment. The outcomes for MRONJ were poor, with 406 reports on zoledronate (31.6%) and 152 reports on denosumab (47.2%) demonstrating nonrecovery. Zoledronate (ROR: 319.3, 95% CI: 296.0–344.4) had the highest ROR among BP agents. Denosumab had a high ROR (ROR: 155.2, 95% CI: 136.5–176.3). Zoledronate and denosumab were used in similar patient backgrounds, and their use resulted in a similar frequency of MRONJ.ConclusionThe findings of this comprehensive evaluation of MRONJ using the JADER database will be helpful for prescribing medications to elderly patients.

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“…Например, T. Mochizuki и соавт. [15] оценили динамику МПК в течение года на фоне терапии ДСБ у 70 паци-ентов с РА и выявили, что прирост МПК в области L I-IV был более высоким (7,3%) по сравнению с ШБ (3,9%) и ПОБ (4,7%). В работе, представленной Т. Suzuki и соавт.…”

Section: Discussionunclassified

Comparative evaluation of denosumab efficacy of in patients with rheumatoid arthritis and postmenopausal osteoporosis: results of 1-year study in clinical practice

Добровольская¹,

Коваленко²,

Торопцова³

et al. 2019

Naučno-praktičeskaâ revmatologiâ

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Objective: to assess bone mineral density (BMD) changes in rheumatoid arthritis (RA) patients with osteoporosis (OP) and in women with postmenopausal OP during therapy with denosumab (DSB) for 1 yearSubjects and methods. 121 women were included: the main group – 69 patients with RA (mean age – 60±7 years), 34 (49.3%) from them received glucocorticoids (GC). Comparison group comprised 52 women with primary OP (mean age – 62±10 years). Measurement of BMD using dual-energy X-ray absorptiometry (DXA) was performed in the lumbar spine (LI–IV), femoral neck (FN), proximal femur as a whole (PF) and distal forearm (DF). DSB was administered subcutaneously at a dose of 60 mg 1 time in 6 months.Results and discussion. In patients with RA, the average increase of BMD for 12 months of treatment was: in LI–IV – 4.6%, in FN-2.8%, in PF-3.0% and in DF-0.7%, and in the comparison group – 5.2; 2.1; 2.9 and 0.9%, respectively. There were no significant differences of BMD changes between the groups. Efficacy of DSB therapy in RA patients with OP did not depend on RA activity, duration of GC therapy and cumulative dose of GC. Adverse events that did not lead to the withdrawal of the drug were noted in 3% of the study participants. There were no fractures during the observation.Conclusion. The efficacy treatment with DSB for 1 year in RA patients with OP and in women with postmenopausal OP is comparable. The use of GC did not have a negative impact on DSB effect.

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Effects of denosumab treatment on bone mineral density and joint destruction in patients with rheumatoid arthritis

Cited by 23 publications

References 23 publications

Effects of denosumab on bone metabolism and bone mineral density with anti-TNF inhibitors, tocilizumab, or abatacept in osteoporosis with rheumatoid arthritis

Effects of denosumab on bone metabolism and bone mineral density with anti-TNF inhibitors, tocilizumab, or abatacept in osteoporosis with rheumatoid arthritis

Evaluation of medication-related osteonecrosis of the jaw using the Japanese Adverse Drug Event Report database

Comparative evaluation of denosumab efficacy of in patients with rheumatoid arthritis and postmenopausal osteoporosis: results of 1-year study in clinical practice

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