Jae-Won Shin1,2, Quen He2, Yong June Suk2, Sang-Ho Kim2, Hak-Sun Kim3. 1. Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Goyang, 10444, Republic of Korea. 2. Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 3. Department of Orthopedic Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. HAKSUNKIM@yuhs.ac.
Abstract
In this retrospective study, the effectiveness of short-term teriparatide with denosumab in reducing fragility fracture risk was determined in comparison with denosumab monotherapy. Administration of sequential teriparatide with denosumab showed excellent outcomes in suppressing the risk for fragility fractures compared with denosumab monotherapy. INTRODUCTION: To determine the effectiveness of short-term teriparatide with denosumab in reducing the risk of fragility fractures in comparison to denosumab monotherapy. METHODS: The data of postmenopausal patients treated with denosumab for > 2 years between August 2015 and October 2020 were retrospectively analyzed. One hundred sixty four postmenopausal women of a total 615 were excluded, since they did not undergo > 2 bone mineral density (BMD) tests, were lost to follow-up, or received long-term teriparatide therapy. Total 320 patients received denosumab monotherapy and 131 patients received teriparatide for ≥ 3 months followed by denosumab. The number of osteoporotic fractures, presence of back pain before and after treatment, and annual BMD during treatment were comparatively assessed using t-test, Chi-square test, and linear mixed model analysis. RESULTS: Before treatment, the denosumab monotherapy group had fewer osteoporotic fractures (mean ± standard deviation; 0.459 ± 0.689) than the sequential therapy group had (1.037 ± 0.871; p < 0.001). After treatment, the sequential therapy group had fewer osteoporotic fractures than the denosumab monotherapy group had (0.119 ± 0.348 versus 0.144 ± 0.385; p < 0.001). At 1 and 2 years after treatment, the increase in lumbar spine BMD was greater in the sequential therapy group than in the denosumab monotherapy group (p = 0.08, group × time). The difference between post and pre-treatment back pain visual analog scale score was significantly lower in the sequential therapy group than in the monotherapy group (3.246 ± 3.426 versus 1.734 ± 3.049; p < 0.001). CONCLUSION: Short-term teriparatide use before denosumab showed excellent outcomes in suppressing the risk of fragility fractures compared with denosumab monotherapy.
In this retrospective study, the effectiveness of short-term teriparatide with denosumab in reducing fragility fracture risk was determined in comparison with denosumab monotherapy. Administration of sequential teriparatide with denosumab showed excellent outcomes in suppressing the risk for fragility fractures compared with denosumab monotherapy. INTRODUCTION: To determine the effectiveness of short-term teriparatide with denosumab in reducing the risk of fragility fractures in comparison to denosumab monotherapy. METHODS: The data of postmenopausal patients treated with denosumab for > 2 years between August 2015 and October 2020 were retrospectively analyzed. One hundred sixty four postmenopausal women of a total 615 were excluded, since they did not undergo > 2 bone mineral density (BMD) tests, were lost to follow-up, or received long-term teriparatide therapy. Total 320 patients received denosumab monotherapy and 131 patients received teriparatide for ≥ 3 months followed by denosumab. The number of osteoporotic fractures, presence of back pain before and after treatment, and annual BMD during treatment were comparatively assessed using t-test, Chi-square test, and linear mixed model analysis. RESULTS: Before treatment, the denosumab monotherapy group had fewer osteoporotic fractures (mean ± standard deviation; 0.459 ± 0.689) than the sequential therapy group had (1.037 ± 0.871; p < 0.001). After treatment, the sequential therapy group had fewer osteoporotic fractures than the denosumab monotherapy group had (0.119 ± 0.348 versus 0.144 ± 0.385; p < 0.001). At 1 and 2 years after treatment, the increase in lumbar spine BMD was greater in the sequential therapy group than in the denosumab monotherapy group (p = 0.08, group × time). The difference between post and pre-treatment back pain visual analog scale score was significantly lower in the sequential therapy group than in the monotherapy group (3.246 ± 3.426 versus 1.734 ± 3.049; p < 0.001). CONCLUSION: Short-term teriparatide use before denosumab showed excellent outcomes in suppressing the risk of fragility fractures compared with denosumab monotherapy.
Authors: Joy N Tsai; Alexander V Uihlein; Sherri-Ann M Burnett-Bowie; Robert M Neer; Yuli Zhu; Nicholas Derrico; Hang Lee; Mary L Bouxsein; Benjamin Z Leder Journal: J Bone Miner Res Date: 2015-01 Impact factor: 6.741
Authors: J N Tsai; A V Uihlein; S M Burnett-Bowie; R M Neer; N P Derrico; H Lee; M L Bouxsein; B Z Leder Journal: J Clin Endocrinol Metab Date: 2016-03-10 Impact factor: 5.958
Authors: Henry G Bone; Rachel B Wagman; Maria L Brandi; Jacques P Brown; Roland Chapurlat; Steven R Cummings; Edward Czerwiński; Astrid Fahrleitner-Pammer; David L Kendler; Kurt Lippuner; Jean-Yves Reginster; Christian Roux; Jorge Malouf; Michelle N Bradley; Nadia S Daizadeh; Andrea Wang; Paula Dakin; Nicola Pannacciulli; David W Dempster; Socrates Papapoulos Journal: Lancet Diabetes Endocrinol Date: 2017-05-22 Impact factor: 32.069
Authors: R M Neer; C D Arnaud; J R Zanchetta; R Prince; G A Gaich; J Y Reginster; A B Hodsman; E F Eriksen; S Ish-Shalom; H K Genant; O Wang; B H Mitlak Journal: N Engl J Med Date: 2001-05-10 Impact factor: 91.245
Authors: Joy N Tsai; Alexander V Uihlein; Hang Lee; Ruchit Kumbhani; Erica Siwila-Sackman; Elizabeth A McKay; Sherri-Ann M Burnett-Bowie; Robert M Neer; Benjamin Z Leder Journal: Lancet Date: 2013-05-15 Impact factor: 79.321
Authors: Benjamin Z Leder; Joy N Tsai; Alexander V Uihlein; Sherri-Ann M Burnett-Bowie; Yuli Zhu; Katelyn Foley; Hang Lee; Robert M Neer Journal: J Clin Endocrinol Metab Date: 2014-02-11 Impact factor: 5.958
Authors: Steven R Cummings; Javier San Martin; Michael R McClung; Ethel S Siris; Richard Eastell; Ian R Reid; Pierre Delmas; Holly B Zoog; Matt Austin; Andrea Wang; Stepan Kutilek; Silvano Adami; Jose Zanchetta; Cesar Libanati; Suresh Siddhanti; Claus Christiansen Journal: N Engl J Med Date: 2009-08-11 Impact factor: 91.245
Authors: Sabashini K Ramchand; Natalie L David; Hang Lee; Michael Bruce; Mary L Bouxsein; Benjamin Z Leder; Joy N Tsai Journal: J Bone Miner Res Date: 2020-09-19 Impact factor: 6.741