دورية أكاديمية
A novel sequential treatment approach between denosumab and romosozumab in patients with severe osteoporosis.
| العنوان: | A novel sequential treatment approach between denosumab and romosozumab in patients with severe osteoporosis. |
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| المؤلفون: | Kumar S; Department of Diabetes & Endocrinology, Westmead Hospital, Sydney, Australia.; Faculty of Medicine & Health, University of Sydney, Sydney, Australia.; Department of Diabetes & Endocrinology, Royal North Shore Hospital, Sydney, Australia., Gild ML; Faculty of Medicine & Health, University of Sydney, Sydney, Australia.; Department of Diabetes & Endocrinology, Royal North Shore Hospital, Sydney, Australia., McDonald MM; Faculty of Medicine, University of New South Wales, Sydney, Australia.; Bone Biology Program, Garvan Institute of Medical Research, Sydney, Australia., Kim AS; Department of Diabetes & Endocrinology, Westmead Hospital, Sydney, Australia.; Faculty of Medicine, University of New South Wales, Sydney, Australia.; Bone Biology Program, Garvan Institute of Medical Research, Sydney, Australia., Clifton-Bligh RJ; Faculty of Medicine & Health, University of Sydney, Sydney, Australia.; Department of Diabetes & Endocrinology, Royal North Shore Hospital, Sydney, Australia., Girgis CM; Department of Diabetes & Endocrinology, Westmead Hospital, Sydney, Australia. Christian.girgis@sydney.edu.au.; Faculty of Medicine & Health, University of Sydney, Sydney, Australia. Christian.girgis@sydney.edu.au. |
| المصدر: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2024 Sep; Vol. 35 (9), pp. 1669-1675. Date of Electronic Publication: 2024 Jun 05. |
| نوع المنشور: | Journal Article; Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: England NLM ID: 9100105 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-2965 (Electronic) Linking ISSN: 0937941X NLM ISO Abbreviation: Osteoporos Int Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London, UK : Springer International, c1990- |
| مواضيع طبية MeSH: | Denosumab*/therapeutic use , Denosumab*/administration & dosage , Bone Density Conservation Agents*/therapeutic use , Bone Density Conservation Agents*/administration & dosage , Bone Density*/drug effects , Osteoporotic Fractures*/prevention & control , Osteoporotic Fractures*/physiopathology , Drug Administration Schedule* , Osteoporosis*/drug therapy , Osteoporosis*/physiopathology , Antibodies, Monoclonal*/administration & dosage , Antibodies, Monoclonal*/therapeutic use, Humans ; Female ; Aged ; Drug Therapy, Combination ; Male ; Bone Remodeling/drug effects ; Middle Aged ; Lumbar Vertebrae/physiopathology |
| مستخلص: | In severe osteoporosis, the optimal approach for sequential treatment between denosumab and romosozumab is unclear. We utilised a novel overlapping strategy in three patients with very-high fracture risk despite long-term denosumab which led to greater bone density improvements than previously reported with standard approaches. Larger confirmatory prospective studies are needed. Purpose/introduction: In patients with severe osteoporosis, the optimal approach for sequential treatment between denosumab and romosozumab has not been established. The ideal strategy would maximise gains in bone mineral density (BMD) with romosozumab and effectively mitigate the risk of rebound increased bone turnover when sequencing from denosumab. Limited studies exploring the sequence from denosumab to romosozumab report only modest-to-no improvement in BMD and inadequate suppression of rebound bone turnover. Methods: We describe three patients with severe osteoporosis and multiple fragility fractures despite long-term denosumab. A novel overlapping sequential treatment approach was utilised to maximise therapeutic benefit given these patients had a very high fracture risk. Romosozumab was commenced 3 months after the last denosumab dose. Instead of waiting until completion of romosozumab, denosumab was recommenced 6 months after commencing romosozumab in response to rising bone turnover markers. Results: Patients experienced a ~ 5-22% increase in lumbar spine BMD, and one patient had an 8% increase in total hip BMD after 12 months romosozumab. Serum bone turnover markers demonstrated an anabolic effect of romosozumab occurred despite overlapping treatment with denosumab. Recommencement of denosumab suppressed an increase in bone resorption in all cases. No new vertebral fractures occurred during this treatment. Conclusions: A novel overlapping sequential treatment approach between denosumab and romosozumab produced greater improvements in lumbar spine and hip BMD than previously reported with standard approaches. Larger prospective controlled studies are needed to confirm these findings and establish the optimal use of romosozumab in patients pre-treated with denosumab to maximise BMD gains and minimise fracture risk. (© 2024. The Author(s).) |
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| فهرسة مساهمة: | Keywords: Denosumab; Osteoporosis; Rebound; Romosozumab; Sequence |
| المشرفين على المادة: | 4EQZ6YO2HI (Denosumab) 3VHF2ZD92J (romosozumab) 0 (Bone Density Conservation Agents) 0 (Antibodies, Monoclonal) |
| تواريخ الأحداث: | Date Created: 20240605 Date Completed: 20240830 Latest Revision: 20240902 |
| رمز التحديث: | 20240902 |
| مُعرف محوري في PubMed: | PMC11364616 |
| DOI: | 10.1007/s00198-024-07139-9 |
| PMID: | 38839655 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1433-2965 |
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| DOI: | 10.1007/s00198-024-07139-9 |