Bone density and remodeling after discontinuation of sequential therapy for premenopausal idiopathic osteoporosis
Authors' conclusion
In premenopausal women with IOP, sequential therapy with teriparatide-denosumab was associated with large gains in bone mass that were maintained by 1 year of bisphosphonate treatment. There was significant bone loss during the first 6 months after discontinuing bisphosphonates, leading to retreatment in about half the participants. Despite this bone loss, BMD remained significantly above pretreatment levels.
Study context
- Population
- Premenopausal women with idiopathic osteoporosis (IOP), aged 44 ± 8, after sequential teriparatide-denosumab and 1 year of bisphosphonate (alendronate or zoledronate)
- Participants
- 19 women
- Exposure
- Resumed bisphosphonates vs Continued observation
- Resumed bisphosphonatesn = 10
- Continued observationn = 9
- Outcome
- Change in BMD and CTX during first 6M off bisphosphonate (12-18M of BES Year 2)
- Follow-up
- 12-18M
Methodological detailssingle-group, observation year off therapy
- Single-group
- Observation year off therapy
Main finding
As reported in the abstract
Spine BMD decline (mean ± SD)
4.2 ± 2.5%
p < 0.05
Total hip BMD decline (mean ± SD)
1.4 ± 2.1%
p < 0.05
CTX increase (mean ± SD)
218 ± 210 pg/ml
p < 0.05
Observational data: associations, not effects.
Further findings
BMD change on sequential teriparatide-denosumab
- Spine BMD increase
- 23 ± 9%
- Total hip BMD increase
- 12 ± 7%
BMD and CTX on bisphosphonate (BES Year 1) · 6M and 12M
- BMD and CTX did not change significantly
Retreatment at 18M
- Resumed bisphosphonates because of bone loss or low BMD
- 10
- Continued observation
- 9
BMD at end of BES Year 2
- Spine BMD stabilized in both groups
- Spine and hip BMD significantly and substantially higher than before teriparatide
Original publication
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