Osteoporos Sarcopenia.  2017 Mar;3(1):45-52. 10.1016/j.afos.2016.12.001.

Bone turnover rate and bone formation/resorption balance during the early stage after switching from a bone resorption inhibitor to denosumab are predictive factors of bone mineral density change

• Nakatoh S

• KMID: 2377002
• DOI: http://doi.org/10.1016/j.afos.2016.12.001

Abstract

OBJECTIVES
This study aimed to investigate the correlation between bone mineral density (BMD) and the turnover rate [√(MoMf²+ MoMr²), multiple of median formation (MoMf) was calculated as bone-specific alkaline phosphatase (BAP) value/18.6 and multiple of median resorption (MoMr) as tartrate-resistant acid phosphatase 5b (TRACP-5b) value/463] and the balance (MoMf/MoMr) and to compare differences in therapeutic effects evoked by differences in previous treatments.
METHODS
In 51 osteoporotic women treated with bisphosphonates (BPs) or selective estrogen receptor modulators (SERMs), BMD was measured at 0, 24, and 48 weeks after denosumab administration. The values of BAP and TRACP-5b were measured at 0, 4, 12, 24, 36, and 48 weeks.
RESULTS
The turnover rate decreased at week 4 and decreased further at week 12. The balance indicated a relative predominantly formative state at week 4. This balance became higher in the SERM group than in the BP group at week 4. A correlation was observed between the rate of BMD change and turnover rate at weeks 0 and 4.
CONCLUSIONS
It is necessary to evaluate the turnover rate and balance to determine the therapeutic effect of denosumab, which induces dissociation between the trends in the bone turnover markers. Turnover rate and balance during the early stages of denosumab treatment may be predictive factors of BMD. When switching from bone resorption inhibitors to denosumab, it was necessary to consider the beginning values that were affected by the previous treatment. The state of relative anabolism is greater at 4 weeks when the previous treatment involved SERMs rather than BPs.

Keyword

Osteoporosis; Denosumab; Bone mineral density; Bone-specific alkaline phosphatase; Tartrate-resistant acid phosphatase 5b

MeSH Terms

Acid Phosphatase
Alkaline Phosphatase
Bone Density Conservation Agents
Bone Density*
Bone Remodeling*
Bone Resorption*
Denosumab*
Diphosphonates
Female
Humans
Metabolism
Osteoporosis
Selective Estrogen Receptor Modulators
Therapeutic Uses
Acid Phosphatase
Alkaline Phosphatase
Bone Density Conservation Agents
Denosumab
Diphosphonates
Selective Estrogen Receptor Modulators
Therapeutic Uses