scholarly journals Denosumab Discontinuation and the Rebound Phenomenon: A Narrative Review

2021 ◽  
Vol 10 (1) ◽  
pp. 152
Author(s):  
Athanasios D. Anastasilakis ◽  
Polyzois Makras ◽  
Maria P. Yavropoulou ◽  
Gaia Tabacco ◽  
Anda Mihaela Naciu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Resorption ◽  
Negative Effects ◽  
Mineral Density ◽  
Skeletal Effects ◽  
Rebound Phenomenon ◽  
Pre Treatment ◽  
Patients Experience ◽  
Multiple Vertebral Fractures ◽  
Optimal Regimen

Denosumab is a potent antiresorptive agent that substantially increases bone mineral density and reduces fracture rates at all skeletal sites for as long as it is administered. However, its favorable skeletal effects reverse quickly upon its discontinuation, because of a vast increase of osteoclast number and activity, which leads to a subsequent profound increase of bone turnover above pre-treatment values, a phenomenon commonly described as “rebound phenomenon”. More importantly, most patients experience rapid, profound bone loss due to this burst of bone resorption that may lead in a minority of these patients to occurrence of fractures, especially multiple vertebral fractures. Therefore, subsequent antiresorptive treatment is mandatory, although the optimal regimen is yet to be clarified. In the present review, we outline what is currently known regarding the negative effects of denosumab discontinuation on different aspects of bone status, the factors that may affect them, and strategies to prevent them.

Changes in bone metabolism associated with exposure to industrial vibration

2020 ◽  
pp. 766-766
Author(s):  
A. V. Sukhova ◽  
E. N. Kryuchkova
Keyword(s):  
Bone Mineral Density ◽  
Alkaline Phosphatase ◽  
Bone Resorption ◽  
Bone Formation ◽  
Bone Metabolism ◽  
Biochemical Markers ◽  
Mineral Density ◽  
Local Vibration ◽  
Markers Of Bone Formation

The influence of general and local vibration on bone remodeling processes is investigated. The interrelations between the long - term exposure of industrial vibration and indicators of bone mineral density (T-and Z-criteria), biochemical markers of bone formation (osteocalcin, alkaline phosphatase) and bone resorption (ionized calcium, calcium/creatinine) were established.

scholarly journals Hip fractures following denosumab discontinuation: three clinical cases reports

2019 ◽  
Vol 112 (11) ◽  
pp. 472-475 ◽  
Author(s):  
Manuel Sosa Henríquez ◽  
María Jesús Gómez de Tejada Romero ◽  
María Escudero-Socorro ◽  
Oscar Torregrosa Suau
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Hip Fractures ◽  
Vertebral Fractures ◽  
Femoral Fractures ◽  
Significant Loss ◽  
Mineral Density ◽  
Denosumab Treatment ◽  
Multiple Vertebral Fractures ◽  
Clinical Cases

Summary A significant loss of bone mineral density and the appearance of multiple vertebral fractures after discontinuation of denosumab treatment have been described. To date, no hip fractures have been reported. We present three cases of patients who suffered femoral fractures after denosumab suppression.

scholarly journals Effects of obesity treatments on bone mineral density, bone turnover and fracture risk in adults with overweight or obesity

2016 ◽  
Vol 28 (3) ◽  
Author(s):  
Claudia Harper ◽  
Andrea L. Pattinson ◽  
Hamish A. Fernando ◽  
Jessica Zibellini ◽  
Radhika V. Seimon ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Dietary Restriction ◽  
Mineral Density ◽  
Pre Treatment ◽  
Obesity Treatments

AbstractBackground:New evidence suggests that obesity is deleterious for bone health, and obesity treatments could potentially exacerbate this.Materials and methods:This narrative review, largely based on recent systematic reviews and meta-analyses, synthesizes the effects on bone of bariatric surgery, weight loss pharmaceuticals and dietary restriction.Results and conclusions:All three obesity treatments result in statistically significant reductions in hip bone mineral density (BMD) and increases in bone turnover relative to pre-treatment values, with the reductions in hip BMD being strongest for bariatric surgery, notably Roux-en Y gastric bypass (RYGB, 8%–11% of pre-surgical values) and weakest for dietary restriction (1%–1.5% of pre-treatment values). Weight loss pharmaceuticals (orlistat or the glucagon-like peptide-1 receptor agonist, liraglutide) induced no greater changes from pre-treatment values than control, despite greater weight loss. There is suggestive evidence that liraglutide may increase bone mineral content (BMC) – but not BMD – and reduce fracture risk, but more research is required to clarify this. All three obesity treatments have variable effects on spine BMD, probably due to greater measurement error at this site in obesity, suggesting that future research in this field could focus on hip rather than spine BMD. Various mechanisms have been proposed for BMD loss with obesity treatments, notably reduced nutritional intake/absorption and insufficient exercise, and these are potential avenues for protection against bone loss. However, a pressing outstanding question is whether this BMD reduction contributes to increased fracture risk, as has been observed after RYGB, and whether any such increase in fracture risk outweighs the risks of staying obese (unlikely).

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