Switching Osteoporosis Therapy to Denosumab Increases Bone Mineral Density

Denosumab (DEN) has shown to increase bone mineral density (BMD) in the past, but it turns out that both treatment-naïve and treated patients can benefit from the medication.

Angela Y Liu, BSc, and colleagues from the University of British Columbia evaluated DEN in a real-world clinic setting. The findings were presented during a poster session at the Endocrine Society’s annual meeting (ENDO 2016) in Boston, Massachusetts.

A total of 758 males and females with osteoporosis received DEN 60 mg subcutaneously for six months to one year. At the start of the study, patients were either treatment-naïve or switched from one of the following medications: alendronate (ALE), risedronate (RIS), zoledronic acid (ZOL), or teriparatide (TER). BMD was measured from the hip or spine at the lowest T-score site once a year.

All of the patients had increased BMD on DEN — with treatment-naïve patients having the biggest increase.

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“Responder analysis showed that 52% and 87% of patients followed at the hip and spine, respectively, had increased BMD by more than 3% by the endo of follow-up at four years,” the authors specified.

The treatment-naïve patients had more improved BMD (no matter if patients were measured in the hip or spine) than those who switched from ZOL. People who switched to DEN from ALE, RIS, and TER all showed similar hip and spine BMD increases when compared to the treatment-naïve group.

The BMD increases were even greater in this real-world study than in previous controlled trials. However, this could have been due to adherence issues. Nevertheless, this analysis gives physicians an idea of BMD improvements to be expected with DEN.

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