Denosumab or oral bisphosphonates in primary osteoporosis: a “real-life” study

E. Cairoli, S. Palmieri, G. Goggi, L. Roggero, M. Arosio, I. Chiodini, C. Eller-Vainicher

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To compare the response to denosumab (DMAb) therapy with that of oral bisphosphonate (BISPH) treatment in postmenopausal women with primary osteoporosis (PO). Methods: In this retrospective study, we compared data of 75 PO female patients treated for 24 months with DMab (DMAb Group, age 72.6 ± 8.9 years) with those of 75 PO patients treated with oral bisphosphonates (BISPH Group), matched for age, body mass index, femoral bone mineral density (BMD), prevalent fragility fractures and familiar history of hip fracture. In all subjects at baseline and after 24 months we assessed the calcium–phosphorous metabolism parameters, BMD at lumbar spine (LS-BMD) and femoral neck (FN-BMD) by dual X-ray absorptiometry and the morphometric vertebral fractures by radiograph. The patients were considered inadequate responders in the presence of ≥ 2 incident fragility fractures and/or a decrease in BMD greater than the least significant change (LS 2.8%, FN 5.9%). Results: After 24 months, the DMab Group showed a greater ALP decrease (− 22.8 ± 18.2%), a higher LS-BMD and FN-BMD increase (6.6 ± 6.9 and 4.4 ± 8.2%, respectively) and a lower number of patients with an incident fracture (8%) and with an inadequate response (6.7%) than BISPH Group (− 14.9 ± 15.3, 2.5 ± 4.3, 1.9 ± 4.5, 21.3 and 22.7%, respectively, p < 0.05 for all comparisons). The inadequate response was 4.5-fold more likely in BISPH Group than in DMab one (p = 0.027), regardless of possible confounders. Conclusions: In postmenopausal PO females, denosumab was more effective than oral bisphosphonates in increasing BMD and reducing bone turnover and the number of inadequate responder patients.

Original languageEnglish
Pages (from-to)1005-1013
Number of pages9
JournalJournal of Endocrinological Investigation
Volume41
Issue number8
DOIs
Publication statusPublished - 2018

Fingerprint

Diphosphonates
Bone Density
Osteoporosis
Age Groups
Postmenopausal Osteoporosis
Denosumab
Bone Remodeling
Femur Neck
Photon Absorptiometry
Hip Fractures
Thigh
Spine
Body Mass Index
Research Design
Retrospective Studies
Therapeutics

Keywords

  • Bone mineral density
  • Denosumab
  • Fragility fractures
  • Oral bisphosphonates

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Denosumab or oral bisphosphonates in primary osteoporosis : a “real-life” study. / Cairoli, E.; Palmieri, S.; Goggi, G.; Roggero, L.; Arosio, M.; Chiodini, I.; Eller-Vainicher, C.

In: Journal of Endocrinological Investigation, Vol. 41, No. 8, 2018, p. 1005-1013.

Research output: Contribution to journalArticle

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abstract = "Purpose: To compare the response to denosumab (DMAb) therapy with that of oral bisphosphonate (BISPH) treatment in postmenopausal women with primary osteoporosis (PO). Methods: In this retrospective study, we compared data of 75 PO female patients treated for 24 months with DMab (DMAb Group, age 72.6 ± 8.9 years) with those of 75 PO patients treated with oral bisphosphonates (BISPH Group), matched for age, body mass index, femoral bone mineral density (BMD), prevalent fragility fractures and familiar history of hip fracture. In all subjects at baseline and after 24 months we assessed the calcium–phosphorous metabolism parameters, BMD at lumbar spine (LS-BMD) and femoral neck (FN-BMD) by dual X-ray absorptiometry and the morphometric vertebral fractures by radiograph. The patients were considered inadequate responders in the presence of ≥ 2 incident fragility fractures and/or a decrease in BMD greater than the least significant change (LS 2.8{\%}, FN 5.9{\%}). Results: After 24 months, the DMab Group showed a greater ALP decrease (− 22.8 ± 18.2{\%}), a higher LS-BMD and FN-BMD increase (6.6 ± 6.9 and 4.4 ± 8.2{\%}, respectively) and a lower number of patients with an incident fracture (8{\%}) and with an inadequate response (6.7{\%}) than BISPH Group (− 14.9 ± 15.3, 2.5 ± 4.3, 1.9 ± 4.5, 21.3 and 22.7{\%}, respectively, p < 0.05 for all comparisons). The inadequate response was 4.5-fold more likely in BISPH Group than in DMab one (p = 0.027), regardless of possible confounders. Conclusions: In postmenopausal PO females, denosumab was more effective than oral bisphosphonates in increasing BMD and reducing bone turnover and the number of inadequate responder patients.",
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T1 - Denosumab or oral bisphosphonates in primary osteoporosis

T2 - a “real-life” study

AU - Cairoli, E.

AU - Palmieri, S.

AU - Goggi, G.

AU - Roggero, L.

AU - Arosio, M.

AU - Chiodini, I.

AU - Eller-Vainicher, C.

PY - 2018

Y1 - 2018

N2 - Purpose: To compare the response to denosumab (DMAb) therapy with that of oral bisphosphonate (BISPH) treatment in postmenopausal women with primary osteoporosis (PO). Methods: In this retrospective study, we compared data of 75 PO female patients treated for 24 months with DMab (DMAb Group, age 72.6 ± 8.9 years) with those of 75 PO patients treated with oral bisphosphonates (BISPH Group), matched for age, body mass index, femoral bone mineral density (BMD), prevalent fragility fractures and familiar history of hip fracture. In all subjects at baseline and after 24 months we assessed the calcium–phosphorous metabolism parameters, BMD at lumbar spine (LS-BMD) and femoral neck (FN-BMD) by dual X-ray absorptiometry and the morphometric vertebral fractures by radiograph. The patients were considered inadequate responders in the presence of ≥ 2 incident fragility fractures and/or a decrease in BMD greater than the least significant change (LS 2.8%, FN 5.9%). Results: After 24 months, the DMab Group showed a greater ALP decrease (− 22.8 ± 18.2%), a higher LS-BMD and FN-BMD increase (6.6 ± 6.9 and 4.4 ± 8.2%, respectively) and a lower number of patients with an incident fracture (8%) and with an inadequate response (6.7%) than BISPH Group (− 14.9 ± 15.3, 2.5 ± 4.3, 1.9 ± 4.5, 21.3 and 22.7%, respectively, p < 0.05 for all comparisons). The inadequate response was 4.5-fold more likely in BISPH Group than in DMab one (p = 0.027), regardless of possible confounders. Conclusions: In postmenopausal PO females, denosumab was more effective than oral bisphosphonates in increasing BMD and reducing bone turnover and the number of inadequate responder patients.

AB - Purpose: To compare the response to denosumab (DMAb) therapy with that of oral bisphosphonate (BISPH) treatment in postmenopausal women with primary osteoporosis (PO). Methods: In this retrospective study, we compared data of 75 PO female patients treated for 24 months with DMab (DMAb Group, age 72.6 ± 8.9 years) with those of 75 PO patients treated with oral bisphosphonates (BISPH Group), matched for age, body mass index, femoral bone mineral density (BMD), prevalent fragility fractures and familiar history of hip fracture. In all subjects at baseline and after 24 months we assessed the calcium–phosphorous metabolism parameters, BMD at lumbar spine (LS-BMD) and femoral neck (FN-BMD) by dual X-ray absorptiometry and the morphometric vertebral fractures by radiograph. The patients were considered inadequate responders in the presence of ≥ 2 incident fragility fractures and/or a decrease in BMD greater than the least significant change (LS 2.8%, FN 5.9%). Results: After 24 months, the DMab Group showed a greater ALP decrease (− 22.8 ± 18.2%), a higher LS-BMD and FN-BMD increase (6.6 ± 6.9 and 4.4 ± 8.2%, respectively) and a lower number of patients with an incident fracture (8%) and with an inadequate response (6.7%) than BISPH Group (− 14.9 ± 15.3, 2.5 ± 4.3, 1.9 ± 4.5, 21.3 and 22.7%, respectively, p < 0.05 for all comparisons). The inadequate response was 4.5-fold more likely in BISPH Group than in DMab one (p = 0.027), regardless of possible confounders. Conclusions: In postmenopausal PO females, denosumab was more effective than oral bisphosphonates in increasing BMD and reducing bone turnover and the number of inadequate responder patients.

KW - Bone mineral density

KW - Denosumab

KW - Fragility fractures

KW - Oral bisphosphonates

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