Clinical Features of 24 Patients With Rebound-Associated Vertebral Fractures After Denosumab Discontinuation: Systematic Review and Additional Cases.
Athanasios D. Anastasilakis,Stergios A. Polyzos,Polyzois Makras,Bérengère Aubry-Rozier,Stella Kaouri,Olivier Lamy +5 more
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TLDR
It is concluded that vertebral fracture(s) after denosumab discontinuation are in the majority of patients multiples, and they occur a few months after the effect of the last dose is depleted, therefore, patients should not delay or omit denOSumab doses.Abstract:
We aimed to study the clinical and imaging characteristics of patients sustaining vertebral fractures after denosumab discontinuation. For this purpose, we conducted a computerized advanced literature search that identified 13 published cases, and we additionally included another 11 new cases from our centers. Twenty-four postmenopausal women with vertebral fracture(s) after denosumab discontinuation, experiencing 112 fractures in total, were analyzed. The mean number of fractures per patient was 4.7. The most commonly affected vertebrae were T12 and L1. All fractures occurred 8 to 16 months after the last denosumab injection. Eighty-three percent of the patients were treatment naive, whereas 33% had prevalent vertebral fractures. Five (23%) patients were on concurrent aromatase inhibitor treatment. When patients were divided according to treatment duration with an arbitrary cut-off of 2 years, those with ≤2 years of denosumab treatment had fewer fractures compared with those with >2 years (mean ± SEM fractures 3.2 ± 0.7 versus 5.2 ± 1.4, p = 0.055). Vertebroplasty was used in 5 patients, resulting in additional clinical vertebral fractures in all cases. We conclude that vertebral fracture(s) after denosumab discontinuation are in the majority of patients multiples, and they occur a few months after the effect of the last dose is depleted. Therefore, patients should not delay or omit denosumab doses. Fractures are typically osteoporotic, located at the lower thoracic and the upper lumbar spine. Vertebroplasty is an unsuccessful treatment strategy for such patients. © 2017 American Society for Bone and Mineral Research.read more
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American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis — 2016
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Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized placebo-controlled FREEDOM trial and its extension
Steven R. Cummings,Serge Ferrari,Richard Eastell,N. Gilchrist,Jens-Erik Beck Jensen,Michael R. McClung,Christian Roux,Ove Tørring,Ivo Valter,A. Wang,Jacques P. Brown +10 more
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Discontinuation of Denosumab therapy for osteoporosis: A systematic review and position statement by ECTS.
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American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaw-2022 Update.
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TL;DR: In this paper , the AAOMS Committee on Oral, Head, and Neck Oncologic and Reconstructive Surgery (COHNORS) and three authors of the 2014 position paper were appointed to serve as a working group to analyze the current literature and revise the guidance as indicated to reflect current knowledge in this field.
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References
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Denosumab for Prevention of Fractures in Postmenopausal Women with Osteoporosis
Steven R. Cummings,Javier San Martin,Michael R. McClung,Ethel S. Siris,Richard Eastell,Ian R. Reid,Pierre D. Delmas,Holly B. Zoog,M. Austin,Andrea Wang,Stepan Kutilek,Silvano Adami,Jose R. Zanchetta,Cesar Libanati,Suresh Siddhanti,Claus Christiansen +15 more
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Henry G. Bone,Michael A. Bolognese,Chui Kin Yuen,David L. Kendler,Paul D. Miller,Y.-C. Yang,Luanda Grazette,Javier San Martin,J. Christopher Gallagher +8 more
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Clinical complications following thyroid fine-needle biopsy: a systematic review
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