Endocrinol Metab.  2021 Aug;36(4):909-911. 10.3803/EnM.2021.1193.

Preventing Rebound-Associated Fractures after Discontinuation of Denosumab Therapy: A Position Statement from the Health Insurance Committee of the Korean Endocrine Society

• Kim BK
• Kim CH
• Min YK

• KMID: 2519679
• DOI: http://doi.org/10.3803/EnM.2021.1193

Figure

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  Fig. 1 Proposed sequential treatment algorithm after denosumab therapy. aIf bisphosphonates are not appropriate, selective estrogen receptor modulator or hormone therapy.

Reference

1. Shoback D, Rosen CJ, Black DM, Cheung AM, Murad MH, Eastell R. Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society guideline update. J Clin Endocrinol Metab. 2020; 105:dgaa048.

2. Camacho PM, Petak SM, Binkley N, Diab DL, Eldeiry LS, Farooki A, et al. American Association of Clinical Endocrinologists/American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update. Endocr Pract. 2020; 26(Suppl 1):1–46.

3. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009; 361:756–65.

4. Bone HG, Wagman RB, Brandi ML, Brown JP, Chapurlat R, Cummings SR, et al. 10 Years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol. 2017; 5:513–23.

5. Brown JP, Roux C, Torring O, Ho PR, Beck Jensen JE, Gilchrist N, et al. Discontinuation of denosumab and associated fracture incidence: analysis from the Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM) trial. J Bone Miner Res. 2013; 28:746–52.

6. Niimi R, Kono T, Nishihara A, Hasegawa M, Kono T, Sudo A. Rebound-associated vertebral fractures after discontinuation of denosumab for the treatment of maxillitis. Osteoporos Int. 2018; 29:769–72.

7. Bone HG, Bolognese MA, Yuen CK, Kendler DL, Miller PD, Yang YC, et al. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2011; 96:972–80.

8. Kendler D, Chines A, Clark P, Ebeling PR, McClung M, Rhee Y, et al. Bone mineral density after transitioning from denosumab to alendronate. J Clin Endocrinol Metab. 2020; 105:e255–64.

9. Tsourdi E, Langdahl B, Cohen-Solal M, Aubry-Rozier B, Eriksen EF, Guanabens N, et al. Discontinuation of denosumab therapy for osteoporosis: a systematic review and position statement by ECTS. Bone. 2017; 105:11–7.

10. Kendler DL, Bone HG, Massari F, Gielen E, Palacios S, Maddox J, et al. Bone mineral density gains with a second 12-month course of romosozumab therapy following placebo or denosumab. Osteoporos Int. 2019; 30:2437–48.

11. Leder BZ, Tsai JN, Uihlein AV, Wallace PM, Lee H, Neer RM, et al. Denosumab and teriparatide transitions in postmenopausal osteoporosis (the DATA-Switch study): extension of a randomised controlled trial. Lancet. 2015; 386:1147–55.