Protective Effect of Denosumab on Bone in Older Women with Primary Hyperparathyroidism

Cristina Eller-Vainicher, Serena Palmieri, Elisa Cairoli, Giovanni Goggi, Alfredo Scillitani, Maura Arosio, Alberto Falchetti, Iacopo Chiodini

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives: To determine the effect of denosumab, which is used in primary osteoporosis (PO), in primary hyperparathyroidism (PHPT)-related osteoporosis. Design: Retrospective, longitudinal study. Setting: Outpatient osteoporosis clinic. Participants: Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density (BMD), and personal history of fragility fractures. Intervention: Twenty-four months of denosumab therapy. Measurements: We assessed the calcium-phosphorus metabolism parameters; BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual X-ray absorptiometry; and morphometric vertebral fractures using radiographs in all subjects at baseline and after 24 months. Changes in BMD and total alkaline phosphatase (ALP) activity were considered significant if they were greater than the least significant change (LS 2.8%, FN 5.9%, TH 4.8%, ALP -22%) and were expressed as percentage difference between end of follow-up and baseline (Δ). Results: After 24 months, women with PHPT had greater ΔALP (-30.6 ± 11.3), ΔFN (5.6 ± 4.8), and ΔTH (4.8 ± 4.4) than those with PO (ΔALP -21.4 ± 13.1, ΔFN 2.9 ± 4.8, ΔTH 1.2 ± 4.1, P < .05 for all comparisons). A significant increase in BMD was more frequent in women with PHPT (92%) than in those with PO (52%, P < .05) and it was 13.4 times as likely in women with PHPT as in those with PO (P = .02), regardless of possible confounders. Two subjects in each group had an incident fracture. Conclusions: Denosumab therapy is effective in older women with PHPT-related osteoporosis.

Original languageEnglish
JournalJournal of the American Geriatrics Society
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Primary Hyperparathyroidism
Osteoporosis
Bone and Bones
Femur Neck
Bone Density
Alkaline Phosphatase
Hip
Spine
Denosumab
Photon Absorptiometry
Hip Fractures
Thigh
Ambulatory Care Facilities
Phosphorus
Longitudinal Studies
Body Mass Index
Retrospective Studies
Calcium
Therapeutics

Keywords

  • Bone mineral density
  • Denosumab
  • Fragility fractures
  • Primary hyperparathyroidism

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{e757eac3bdc44d82ae8852c5bb8ddbb3,
title = "Protective Effect of Denosumab on Bone in Older Women with Primary Hyperparathyroidism",
abstract = "Objectives: To determine the effect of denosumab, which is used in primary osteoporosis (PO), in primary hyperparathyroidism (PHPT)-related osteoporosis. Design: Retrospective, longitudinal study. Setting: Outpatient osteoporosis clinic. Participants: Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density (BMD), and personal history of fragility fractures. Intervention: Twenty-four months of denosumab therapy. Measurements: We assessed the calcium-phosphorus metabolism parameters; BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual X-ray absorptiometry; and morphometric vertebral fractures using radiographs in all subjects at baseline and after 24 months. Changes in BMD and total alkaline phosphatase (ALP) activity were considered significant if they were greater than the least significant change (LS 2.8{\%}, FN 5.9{\%}, TH 4.8{\%}, ALP -22{\%}) and were expressed as percentage difference between end of follow-up and baseline (Δ). Results: After 24 months, women with PHPT had greater ΔALP (-30.6 ± 11.3), ΔFN (5.6 ± 4.8), and ΔTH (4.8 ± 4.4) than those with PO (ΔALP -21.4 ± 13.1, ΔFN 2.9 ± 4.8, ΔTH 1.2 ± 4.1, P < .05 for all comparisons). A significant increase in BMD was more frequent in women with PHPT (92{\%}) than in those with PO (52{\%}, P < .05) and it was 13.4 times as likely in women with PHPT as in those with PO (P = .02), regardless of possible confounders. Two subjects in each group had an incident fracture. Conclusions: Denosumab therapy is effective in older women with PHPT-related osteoporosis.",
keywords = "Bone mineral density, Denosumab, Fragility fractures, Primary hyperparathyroidism",
author = "Cristina Eller-Vainicher and Serena Palmieri and Elisa Cairoli and Giovanni Goggi and Alfredo Scillitani and Maura Arosio and Alberto Falchetti and Iacopo Chiodini",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/jgs.15250",
language = "English",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Blackwell Publishing Inc.",

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TY - JOUR

T1 - Protective Effect of Denosumab on Bone in Older Women with Primary Hyperparathyroidism

AU - Eller-Vainicher, Cristina

AU - Palmieri, Serena

AU - Cairoli, Elisa

AU - Goggi, Giovanni

AU - Scillitani, Alfredo

AU - Arosio, Maura

AU - Falchetti, Alberto

AU - Chiodini, Iacopo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: To determine the effect of denosumab, which is used in primary osteoporosis (PO), in primary hyperparathyroidism (PHPT)-related osteoporosis. Design: Retrospective, longitudinal study. Setting: Outpatient osteoporosis clinic. Participants: Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density (BMD), and personal history of fragility fractures. Intervention: Twenty-four months of denosumab therapy. Measurements: We assessed the calcium-phosphorus metabolism parameters; BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual X-ray absorptiometry; and morphometric vertebral fractures using radiographs in all subjects at baseline and after 24 months. Changes in BMD and total alkaline phosphatase (ALP) activity were considered significant if they were greater than the least significant change (LS 2.8%, FN 5.9%, TH 4.8%, ALP -22%) and were expressed as percentage difference between end of follow-up and baseline (Δ). Results: After 24 months, women with PHPT had greater ΔALP (-30.6 ± 11.3), ΔFN (5.6 ± 4.8), and ΔTH (4.8 ± 4.4) than those with PO (ΔALP -21.4 ± 13.1, ΔFN 2.9 ± 4.8, ΔTH 1.2 ± 4.1, P < .05 for all comparisons). A significant increase in BMD was more frequent in women with PHPT (92%) than in those with PO (52%, P < .05) and it was 13.4 times as likely in women with PHPT as in those with PO (P = .02), regardless of possible confounders. Two subjects in each group had an incident fracture. Conclusions: Denosumab therapy is effective in older women with PHPT-related osteoporosis.

AB - Objectives: To determine the effect of denosumab, which is used in primary osteoporosis (PO), in primary hyperparathyroidism (PHPT)-related osteoporosis. Design: Retrospective, longitudinal study. Setting: Outpatient osteoporosis clinic. Participants: Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density (BMD), and personal history of fragility fractures. Intervention: Twenty-four months of denosumab therapy. Measurements: We assessed the calcium-phosphorus metabolism parameters; BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH) using dual X-ray absorptiometry; and morphometric vertebral fractures using radiographs in all subjects at baseline and after 24 months. Changes in BMD and total alkaline phosphatase (ALP) activity were considered significant if they were greater than the least significant change (LS 2.8%, FN 5.9%, TH 4.8%, ALP -22%) and were expressed as percentage difference between end of follow-up and baseline (Δ). Results: After 24 months, women with PHPT had greater ΔALP (-30.6 ± 11.3), ΔFN (5.6 ± 4.8), and ΔTH (4.8 ± 4.4) than those with PO (ΔALP -21.4 ± 13.1, ΔFN 2.9 ± 4.8, ΔTH 1.2 ± 4.1, P < .05 for all comparisons). A significant increase in BMD was more frequent in women with PHPT (92%) than in those with PO (52%, P < .05) and it was 13.4 times as likely in women with PHPT as in those with PO (P = .02), regardless of possible confounders. Two subjects in each group had an incident fracture. Conclusions: Denosumab therapy is effective in older women with PHPT-related osteoporosis.

KW - Bone mineral density

KW - Denosumab

KW - Fragility fractures

KW - Primary hyperparathyroidism

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