Research Article
Volume 9 Issue 12 - 2020
Long Term Effect of Denosumab on Densitometry Evolution in Women Patients
Gonzalez Lissette Alejandra* and Rodriguez MA
HM Hospitalez, Spain
*Corresponding Author: Gonzalez Lissette Alejandra, HM Hospitalez, Spain.
Received: July 14, 2020; Published: November 30, 2020




Abstract

Introduction: Osteoporosis is one of the most common bone disease in the world. The side effect associate to bone fractures increases the morbidity and mortality especially in aging women.

Recently, a monoclonal antibody directed against activator nuclear factor k B ligand receptor (RANKL) denominated Denosumab has been approved as an initial therapy for bone fracture high risk patients (e.g. aging, bisphosphonates intolerant or contraindicated).

Denosumab exert their effect inhibiting the osteoclasts function and decreasing the bone resorption. Several studies have demonstrated that Denosumab increased dual-energy X-ray absorptiometry (DXA) areal bone mineral density (aBMD) and decreased the bone turnover as well as the risk of new vertebral, non-vertebral, and hip fractures. However, the level of response to treatment with Denosumab among patients with or without osteoporosis in a long term evaluated by densitometry is unknown. The aim of this study is (a) to identify the proportion of women that decrease the bone density after starting the Denosumab treatment and (b) to identify factors associate to the decreasing bone density in women receiving Denosumab.

Materials and Methods: This retrospective, unicenter and real world study was conducted in the Gynaecology Unit of HM Hospitals during January 2013 to December 2015. Inclusion criteria: women older than 40 years old medicated with denosumab and with two consecutives densitometries.

T0 include all variables and the densitometry result immediately before the Denosumab treatment was prescribed. Then densitometries were routinely performed at 2 - 3 years, at 4 - 5 years and 6 - 7 years from treatment prescription. Treatment failure was considered when the second densitometry was lower than 2.7% regarding the previous.

Results: During the study period 834 patients have received Denosumab; The final sample included 365 patients of which 123 patients (33,6%) not reduce more than 2.7% at any time compared to the previous densitometry, (considering no decrease at the femoral or lumbar level).

When analyzing each one of the variables with its association to the failure of the treatment with Denosumab, none of the variables allows to predict which patient will respond or not to the treatment.

Conclusion: More studies are needed to validate these results and find other factors that may influence the response to Denosumab during long-term treatment and also assess the risk of fractures in patients who do not respond adequately to treatment.

Keywords: Osteoporosis; RANKL; Dual-Energy X-Ray Absorptiometry (DXA); Areal Bone Mineral Density (aBMD)

References

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Citation: Gonzalez Lissette Alejandra and Rodriguez MA. “Long Term Effect of Denosumab on Densitometry Evolution in Women Patients”. EC Gynaecology 9.12 (2020): 67-73.

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