Discontinuing Denosumab: Can It Be Done Safely? A Review of the Literature
Endocrinology and Metabolism
;
: 183-194, 2022.
Article
in English
| WPRIM
| ID: wpr-924940
ABSTRACT
Denosumab, which has been approved for the treatment of osteoporosis since 2010, is a fully humanised monoclonal antibody against a cytokine, receptor activator of nuclear factor kappa B ligand (RANKL), involved in bone resorption. Continued use of denosumab results in a potent and sustained decrease in bone turnover, an increase in bone mineral density (BMD), and a reduction in vertebral and hip fractures. The anti-resorptive effects of denosumab are reversible upon cessation, and this reversal is accompanied by a transient marked increase in bone turnover that is associated with bone loss, and of concern, an increased risk of multiple vertebral fractures. In this review, we outline the effects of denosumab withdrawal on bone turnover markers, BMD, histomorphometry, and fracture risk. We provide an update on recent clinical trials that sought to answer how clinicians can transition away from denosumab safely with follow-on therapy to mitigate bone loss and summarise the recommendations of various international guidelines.
Full text:
Available
Index:
WPRIM (Western Pacific)
Type of study:
Practice guideline
Language:
English
Journal:
Endocrinology and Metabolism
Year:
2022
Type:
Article
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