Evaluation of Denosumab Efficacy after Bisphosphonate Use in Patients with Osteoporosis: A Single Center Experience

ABSTRACT
Objective: Osteoporosis is a disease in which the bone mass and structure are weakened as a result of the decrease in the mineral density in the bones, and the bones become brittle. In addition to the use of adequate calcium and vitamin D in the treatment of osteoporosis, drugs that prevent bone resorption and increase bone formation are used. The aim of this study was to evaluate the efficacy and safety of denosumab after the use of bisphosphonates in the Turkish population with osteoporosis.
Materials and Methods: Patients diagnosed with osteoporosis and using denosumab between 2018-2022 were involved in the study. Demographic, clinical, bone mineral density, and treatment characteristics of the patients were recorded. The patient's bone mineral density values after denosumab were compared with the baseline values.
Results: Analysis of the study was performed with data from 55 patients. All patients involved in the study were female, and the median age was 69 (46-90). The most common cause of osteoporosis was postmenopausal (56.4%), and the most common cause among secondary causes was primary hyperparathyroidism (14.5%). Fourteen (25.5%) patients had a history of fracture. After denosumab treatment, a statistically significant decrease was detected in the phosphorus (p=0.022) and alkaline phosphatase (p<0.001) levels of the patients. Improvement was observed in BMD (gr/cm2) values of L1-L4 (from 0.887 to 0.933), femoral neck (from 0.693 to 0.727), and total hip (from 0.762 to 0.782) regions with denosumab treatment. Similarly, the patients’ BMD Z scores and T scores were improved. Also, the denosumabrelated adverse event was not observed.
Conclusions: In this study, treatment characteristics of osteoporosis patients were retrospectively examined. Denosumab was well tolerated in patients, and no serious treatment-related side effects were detected. After bisphosphonate use, denosumab was shown to be an effective and safe treatment option in the treatment of osteoporosis.
Keywords: Osteoporosis, bisphosphonate, denosumab