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Bone. 2019 Mar;120:44-49. doi: 10.1016/j.bone.2018.10.001. Epub 2018 Oct 4.

Denosumab effects on bone density and turnover in postmenopausal women with low bone mass with or without previous treatment.

Author information

1
Department of Medicine III, Technische Universität Dresden Medical Center, Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany.
2
Department of Endocrinology and Diabetes, 251 Hellenic Force & VA General Hospital, Athens, Greece.
3
First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Greece.
4
Department of Endocrinology, 424 General Military Hospital, 54638 Thessaloniki, Greece.
5
Department of Medicine III, Technische Universität Dresden Medical Center, Dresden, Germany; Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany; Center for Regenerative Therapies Dresden, Technische Universität Dresden, Germany.
6
Department of Endocrinology, 424 General Military Hospital, 54638 Thessaloniki, Greece. Electronic address: a.anastasilakis@gmail.com.

Abstract

PURPOSE:

Prior osteoporosis therapies may affect the skeletal response to denosumab. We compared the effect of denosumab (60 mg every 6 months for 12 months) on bone mineral density and bone metabolism parameters in postmenopausal women with low bone mass who were either treatment-naïve (n = 30), or previously treated either with zoledronic acid (n = 30), or teriparatide (n = 22).

METHODS:

We assessed lumbar spine bone mineral density (BMD) and measured serum concentrations of the bone turnover markers pro-collagen type 1 N-terminal propeptide (PINP) and C-terminal-cross-linking telopeptide of type 1 collagen (CTX), as well as sclerostin, dickkopf-1 (Dkk-1), and myostatin.

RESULTS:

Lumbar spine BMD increased equivalently in all three groups after 12 months of denosumab compared to baseline (p < 0.001). Serum PINP and CTX decreased significantly with denosumab in pre-treated women reaching the same nadir levels as in treatment-naïve patients (p < 0.001). Women pre-treated with teriparatide displayed lower baseline myostatin concentrations as compared to the other two groups (p < 0.001). Changes in lumbar spine BMD in teriparatide pre-treated women correlated with changes in bone turnover markers and myostatin.

CONCLUSIONS:

Denosumab induced similar increases in lumbar spine BMD in treatment-naïve and pre-treated patients and suppressed serum PINP and CTX to the same levels regardless of prior treatments. In teriparatide pre-treated patients the magnitude of change in bone turnover markers is associated with BMD response.

KEYWORDS:

Bone remodeling; Denosumab; Myostatin; Teriparatide; Wnt-inhibitors; Zoledronic acid

PMID:
30292818
DOI:
10.1016/j.bone.2018.10.001

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