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The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study

PURPOSE: To investigate changes in bone mineral density (BMD) following denosumab after previous bisphosphonate therapy and the impact of chronic kidney disease (CKD) on response. METHODS: A retrospective study of 134 patients (11 M, 123 F) aged [mean (SD)] 72 [11] years on denosumab was undertaken....

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Autores principales: Fraser, T. R., Flogaitis, I., Moore, A. E., Hampson, G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067751/
https://www.ncbi.nlm.nih.gov/pubmed/31664706
http://dx.doi.org/10.1007/s40618-019-01131-5
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author Fraser, T. R.
Flogaitis, I.
Moore, A. E.
Hampson, G.
author_facet Fraser, T. R.
Flogaitis, I.
Moore, A. E.
Hampson, G.
author_sort Fraser, T. R.
collection PubMed
description PURPOSE: To investigate changes in bone mineral density (BMD) following denosumab after previous bisphosphonate therapy and the impact of chronic kidney disease (CKD) on response. METHODS: A retrospective study of 134 patients (11 M, 123 F) aged [mean (SD)] 72 [11] years on denosumab was undertaken. Ninety-five patients had previously been on oral and 28 on iv bisphosphonate. Lumbar spine (LS), total hip (TH) and femoral neck (FN) BMD were measured before treatment and at 2.7 [1.2] years. GFR was < 35 ml/min in 24 patients (18%). Ninety-four (18 M, 76 F) patients aged 71 [11] years transitioning to zoledronate were also studied. RESULTS: BMD improved following denosumab [mean (SEM) % change LS: 6.0 (0.62) p < 0.001, TH: 2.28 (0.64) p < 0.001, FN: 1.9 (0.77) p = 0.045]. Changes at the TH and FN were lower in patients with GFR < 35 ml/min (Group B) compared to those with GFR > 35 ml/min (Group A) [% change TH; Group A: 2.9 (0.72), Group B: − 0.84 (1.28), p = 0.015, FN; Group A: 2.76 (0.86), Group B: − 1.47 (1.53), p = 0.025]. % change in BMD at the FN and PTH were negatively associated (r = − 0.25, p = 0.013). BMD changes were not different at 12–18 months between patients on denosumab compared to zoledronate [% change at LS: denosumab: 3.97% (0.85), zoledronate: 2.6% (0.5), p = 0.19 TH: denosumab: 0.97% (0.58), zoledronate: 0.92% (0.6), p = 0.95). CONCLUSION: Denosumab increases BMD following previous bisphosphonate treatment and is comparable to zoledronate. Lower response seen at the hip in CKD is related to PTH concentrations.
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spelling pubmed-70677512020-03-23 The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study Fraser, T. R. Flogaitis, I. Moore, A. E. Hampson, G. J Endocrinol Invest Original Article PURPOSE: To investigate changes in bone mineral density (BMD) following denosumab after previous bisphosphonate therapy and the impact of chronic kidney disease (CKD) on response. METHODS: A retrospective study of 134 patients (11 M, 123 F) aged [mean (SD)] 72 [11] years on denosumab was undertaken. Ninety-five patients had previously been on oral and 28 on iv bisphosphonate. Lumbar spine (LS), total hip (TH) and femoral neck (FN) BMD were measured before treatment and at 2.7 [1.2] years. GFR was < 35 ml/min in 24 patients (18%). Ninety-four (18 M, 76 F) patients aged 71 [11] years transitioning to zoledronate were also studied. RESULTS: BMD improved following denosumab [mean (SEM) % change LS: 6.0 (0.62) p < 0.001, TH: 2.28 (0.64) p < 0.001, FN: 1.9 (0.77) p = 0.045]. Changes at the TH and FN were lower in patients with GFR < 35 ml/min (Group B) compared to those with GFR > 35 ml/min (Group A) [% change TH; Group A: 2.9 (0.72), Group B: − 0.84 (1.28), p = 0.015, FN; Group A: 2.76 (0.86), Group B: − 1.47 (1.53), p = 0.025]. % change in BMD at the FN and PTH were negatively associated (r = − 0.25, p = 0.013). BMD changes were not different at 12–18 months between patients on denosumab compared to zoledronate [% change at LS: denosumab: 3.97% (0.85), zoledronate: 2.6% (0.5), p = 0.19 TH: denosumab: 0.97% (0.58), zoledronate: 0.92% (0.6), p = 0.95). CONCLUSION: Denosumab increases BMD following previous bisphosphonate treatment and is comparable to zoledronate. Lower response seen at the hip in CKD is related to PTH concentrations. Springer International Publishing 2019-10-29 2020 /pmc/articles/PMC7067751/ /pubmed/31664706 http://dx.doi.org/10.1007/s40618-019-01131-5 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Fraser, T. R.
Flogaitis, I.
Moore, A. E.
Hampson, G.
The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title_full The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title_fullStr The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title_full_unstemmed The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title_short The effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
title_sort effect of previous treatment with bisphosphonate and renal impairment on the response to denosumab in osteoporosis: a ‘real-life’ study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067751/
https://www.ncbi.nlm.nih.gov/pubmed/31664706
http://dx.doi.org/10.1007/s40618-019-01131-5
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