TY - JOUR
T1 - Denosumab Discontinuation
AU - Sølling, Anne Sophie
AU - Tsourdi, Elena
AU - Harsløf, Torben
AU - Langdahl, Bente Lomholt
PY - 2023/2
Y1 - 2023/2
N2 - Purpose of Review: To review the pathophysiology, the clinical consequences as well as way of mitigating the effects of denosumab discontinuation. Recent Findings: Treatment with denosumab (DMAB) is reversible and upon discontinuation there is a rapid increase in bone turnover and a subsequent bone loss. During this phase of high bone turnover, an increased risk of fractures has been reported. Therefore, treatment with DMAB could be considered life-long. However, side-effects may prompt the need for discontinuation and moreover, treatment with DMAB may have increased BMD to levels where continuing treatment does not provide further fracture risk reduction. Patients stopping DMAB should be offered subsequent antiresorptive treatment with an intense monitoring regimen during the initial year as most of the bone loss occurs within these initial 12 months. Summary: In this review, we evaluated the literature published over the past 1 to 3 years investigating DMAB withdrawal with focus on bone turnover markers, bone mineral density, and fracture risk and the transition to other anti-osteoporosis therapies. Furthermore, we summarized the current recommendations of international guidelines. Mini Abstract: In this review, we evaluated the literature published over the past 1 to 3 years investigating denosumab (DMAB) discontinuation and the transition to other anti-osteoporosis therapies. Additionally, we summarized the current recommendations of international guidelines.
AB - Purpose of Review: To review the pathophysiology, the clinical consequences as well as way of mitigating the effects of denosumab discontinuation. Recent Findings: Treatment with denosumab (DMAB) is reversible and upon discontinuation there is a rapid increase in bone turnover and a subsequent bone loss. During this phase of high bone turnover, an increased risk of fractures has been reported. Therefore, treatment with DMAB could be considered life-long. However, side-effects may prompt the need for discontinuation and moreover, treatment with DMAB may have increased BMD to levels where continuing treatment does not provide further fracture risk reduction. Patients stopping DMAB should be offered subsequent antiresorptive treatment with an intense monitoring regimen during the initial year as most of the bone loss occurs within these initial 12 months. Summary: In this review, we evaluated the literature published over the past 1 to 3 years investigating DMAB withdrawal with focus on bone turnover markers, bone mineral density, and fracture risk and the transition to other anti-osteoporosis therapies. Furthermore, we summarized the current recommendations of international guidelines. Mini Abstract: In this review, we evaluated the literature published over the past 1 to 3 years investigating denosumab (DMAB) discontinuation and the transition to other anti-osteoporosis therapies. Additionally, we summarized the current recommendations of international guidelines.
KW - Bone mineral density
KW - Bone turnover markers
KW - Denosumab
KW - Fracture
KW - Osteoporosis
KW - Osteoporosis, Postmenopausal/drug therapy
KW - Bone Density
KW - Denosumab/therapeutic use
KW - Humans
KW - Fractures, Bone/chemically induced
KW - Female
KW - Bone Density Conservation Agents/adverse effects
UR - http://www.scopus.com/inward/record.url?scp=85144679328&partnerID=8YFLogxK
U2 - 10.1007/s11914-022-00771-6
DO - 10.1007/s11914-022-00771-6
M3 - Review
C2 - 36564572
SN - 1544-1873
VL - 21
SP - 95
EP - 103
JO - Current Osteoporosis Reports
JF - Current Osteoporosis Reports
IS - 1
ER -