The Effect of Denosumab in Elderly Patients Regarding Bone Density and Fracture Risk
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Background: With an aging population, the importance of treating and diagnosing osteoporosis is increasing. Osteoporosis, previously known as a resorptive change primarily related to endocrinological mechanisms, is also being approached as a phenomenon of senile change. Denosumab is gaining popularity among osteoporosis medications due to its ability to increase bone mineral density (BMD) and the economic benefit arising from the 6-month cycle. In line with previous literature, this study aimed to examine the BMD-augmenting effect of denosumab through which it reduces fracture risk in individuals aged over 80 years. Methods: We reviewed patients who received denosumab between 2018 and 2022 with a minimum clinical observation period of 12 months. BMD was measured every 12 months, and patients were classified per their period of denosumab use. Fracture risk was evaluated using the fracture risk assessment tool (FRAX) and fracture incidence during the observation period were assessed. Results: Among 155 patients, a significant increase in BMD was observed at 3 sites: the lumbar spine, femoral neck, and total hip (P<0.001, P<0.001, and P=0.001, respectively). The patients were divided according to the length of clinical follow-up they received, and similar results were found in all subgroups. Fracture risk assessment was performed using FRAX and the incidence of fracture events during follow-up. FRAX significantly decreased in all subgroups except those who received 24 months of follow-up (P=0.003, P=0.41, P=0.001 in the 12, 24, and ≥36 months groups, respectively). Conclusions: Denosumab use resulted in long-term BMD increase and reduced fracture risk in individuals aged 80 and above.
Abstract
Background: With an aging population, the importance of treating and diagnosing osteoporosis is increasing. Osteoporosis, previously known as a resorptive change primarily related to endocrinological mechanisms, is also being approached as a phenomenon of senile change. Denosumab is gaining popularity among osteoporosis medications due to its ability to increase bone mineral density (BMD) and the economic benefit arising from the 6-month cycle. In line with previous literature, this study aimed to examine the BMD-augmenting effect of denosumab through which it reduces fracture risk in individuals aged over 80 years. Methods: We reviewed patients who received denosumab between 2018 and 2022 with a minimum clinical observation period of 12 months. BMD was measured every 12 months, and patients were classified per their period of denosumab use. Fracture risk was evaluated using the fracture risk assessment tool (FRAX) and fracture incidence during the observation period were assessed. Results: Among 155 patients, a significant increase in BMD was observed at 3 sites: the lumbar spine, femoral neck, and total hip (P<0.001, P<0.001, and P=0.001, respectively). The patients were divided according to the length of clinical follow-up they received, and similar results were found in all subgroups. Fracture risk assessment was performed using FRAX and the incidence of fracture events during follow-up. FRAX significantly decreased in all subgroups except those who received 24 months of follow-up (P=0.003, P=0.41, P=0.001 in the 12, 24, and ≥36 months groups, respectively). Conclusions: Denosumab use resulted in long-term BMD increase and reduced fracture risk in individuals aged 80 and above.
참고문헌 (22)
- "2022 Statistics for the elderly" (2022)[URL]
- Jae Young Lim, "Fracture Liaison Service in Korea: 2022 Position Statement of the Korean Society for Bone and Mineral Research", 대한골대사학회지, 30(1), pp.31~36 (2023), 대한골대사학회
- Korean Society for Bone and Mineral Research, "Fracture liaison services guidebook" (2018), Korean Society for Bone and Mineral Research
- Khosla S, "Pathogenesis of age-related bone loss in humans", J Gerontol A Biol Sci Med Sci, 68, pp.1226~1235 (2013)[DOI]
- 오형근, "골절 후 골다공증의 약물치료 및 낙상 예방", 대한골절학회지, 31(4), pp.165~171 (2018), 대한골절학회[DOI]
- Nakamura T, "Clinical trials express : fracture risk reduction with denosumab in Japanese postmenopausal women and men with osteoporosis : Denosumab fracture intervention randomized placebo controlled trial(DIRECT)", J Clin Endocrinol Metab, 99, pp.2599~2607 (2014)[DOI]
- Boonen S, "Treatment with denosumab reduces the incidence of new vertebral and hip fractures in postmenopausal women at high risk", J Clin Endocrinol Metab, 96, pp.1727~1736 (2011)[DOI]
- Chaiho Jeong, "The Effect of Denosumab on Bone Mass in Super Elderly Patients", 대한골대사학회지, 27(2), pp.119~124 (2020), 대한골대사학회
- Silverman SL, "The utility and limitations of FRAX : a US perspective", Curr Osteoporos Rep, 8, pp.192~197 (2010)[DOI]
- Tai TW, "Refracture risk and all-cause mortality after vertebral fragility fractures : anti-osteoporotic medications matter", J Formos Med Assoc, pp.1~9 (2023)[DOI]
- 안승희, "Osteoporosis and Osteoporotic Fracture Fact Sheet in Korea", 대한골대사학회지, 27(4), pp.281~290 (2020), 대한골대사학회
- Baim S, "Approaches to fracture risk assessment and prevention", Curr Osteoporos Rep, 19, pp.158~165 (2021)[DOI]
- Iacovino JR, "Mortality outcomes after osteoporotic fractures in men and women", J Insur Med, 33, pp.316~320 (2001)
- Thal KA, "Denosumab versus bisphosphonates for reducing fractures in postmenopausal women with osteoporosis : a meta-analysis", J Am Board Fam Med, 36, pp.175~185 (2023)[DOI]
- Okubo N, "Relationship between bone mineral density and risk of vertebral fractures with denosumab treatment in Japanese postmenopausal women and men with osteoporosis", Calcif Tissue Int, 107, pp.559~566 (2020)[DOI]
- Pang KL, "A review on the role of denosumab in fracture prevention", Drug Des Devel Ther, 14, pp.4029~4051 (2020)[DOI]
- Shin JW, "Comparison of the efficacy between sequential therapy with teriparatide and denosumab and denosumab monotherapy in suppressing fragility fracture risk", Osteoporos Int, 33, pp.2409~2416 (2022)[DOI]
- Mackey DC, "Effects of antiresorptive treatment on nonvertebral fracture outcomes", J Bone Miner Res, 26, pp.2411~2418 (2011)[DOI]
- Çiğiloğlu A, "How to treat osteoporosis in octogenarians?", Eur J Geriatric Gerontol, 4, pp.114~118 (2022)[DOI]
- Qu XL, "Bone turnover markers and bone mineral density to predict osteoporotic fractures in older women : a retrospective comparative study", Orthop Surg, 12, pp.116~123 (2020)[DOI]
- Anastasilakis AD, "Zoledronate for the prevention of bone loss in women discontinuing denosumab treatment. A prospective 2-year clinical trial", J Bone Miner Res, 34, pp.2220~2228 (2019)[DOI]
- Eastell R, "Postmenopausal osteoporosis", Nat Rev Dis Primers, 2, pp.16069~ (2016)[DOI]