Bone loss after denosumab discontinuation is prevented by alendronate and zoledronic acid but not risedronate: a retrospective study
Authors' conclusion
Subsequent treatment with ALN or ZOL but not NT and RIS mitigates BMD loss after Dmab discontinuation.
Study context
- Population
- Patients aged 71.2 ± 8.1 years discontinuing denosumab (mean 5.4 doses)88 received bisphosphonate (BP)
- Participants
- 121 patients
- Exposure
- No treatment vs risedronate, alendronate or zoledronic acid after denosumab (Dmab) discontinuation
- No treatment (NT)n = 33reference
- Risedronate (RIS)n = 22
- Alendronate (ALN)n = 34
- ZOLn = 32
- Outcome
- BMD change at LS, femoral neck and total hip
- Follow-up
- 1 year
Main finding
As reported in the abstract
LS BMD mean change (g/cm²)
NT
- 0.041
mean · 95% CI - 0.062 to - 0.021 · g/cm²
RIS
- 0.035
mean · 95% CI - 0.052 to - 0.017 · g/cm²
ALN
- 0.005
mean · 95% CI - 0.020 to 0.009 · g/cm²
ZOL
- 0.009
mean · 95% CI - 0.025 to 0.008 · g/cm²
NT vs ALN: P = 0.015 · NT vs ZOL: P = 0.037
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Total hip BMD change · 1 yearNT vs ZOL · only significant TH difference | p 0.034 |
Femoral neck bone mineral density (BMD) change · 1 year
- No group differences in femoral neck (FN)
BMD after >5 Dmab doses, ALN vs ZOL (subset)
- No difference in BMD between ALN (n = 22) and ZOL (n = 11)
Predictor of BMD loss
- BMD gains during Dmab treatment associated with BMD loss after discontinuation
Safety
- 5 of 7 vertebral fractures occurred after Dmab discontinuation in NT
Original publication
Bone loss after denosumab discontinuation is prevented by alendronate and zoledronic acid but not risedronate: a retrospective study. Osteoporos Int. Published 5 January 2023. doi:10.
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