Bisphosphonates Maintain Bone Mineral Density (BMD) After Sequential Teriparatide and Denosumab in Premenopausal Women with Idiopathic Osteoporosis
Authors' conclusion
BMD remained stable in women with PremenIOP who received bisphosphonates after sequential teriparatide-denosumab therapy.
Study context
- Population
- Premenopausal women with idiopathic osteoporosis after sequential teriparatide-denosumab (premenopausal idiopathic osteoporosis (PremenIOP) Teriparatide-Denosumab Study participants), aged 43 ± 8 years; bisphosphonate given 7 M after final denosumab dose
- Participants
- 24 women
- Comparison
- Oral alendronate (ALN) vs IV ZOL after denosumab cessation
- ALNn = 18
- ZOLn = 6
- Outcome
- Whether bisphosphonates after denosumab cessation are associated with stable BMD
- Follow-up
- 6 and 12 M
Main finding
As reported in the abstract
BMD and CTX change, entire group · 6 or 12 M
- Mean BMD and CTX changes in the entire group were small and not statistically significant
Further findings
Lumbar spine BMD and CTX by bisphosphonate · 6 M to 12 M
- On ZOL, small lumbar spine BMD declines and CTX increases, particularly between 6 M and 12 M; greater stability on ALN
BMD and CTX changes by denosumab duration (36 M vs <36 M) and menopausal status (20 premenopausal vs 4 transitioned)
- Changes in BMD and CTX did not differ by denosumab duration or menopausal transition
Predictor of bone loss
- Higher pre-teriparatide CTX predicted more spine and hip bone loss
BMD increase on prior sequential teriparatide-denosumab
- Spine BMD increase
- 25 ± 9%
- Total hip BMD increase
- 11 ± 6%
Safety
- New vertebral (clinical or Vertebral Fracture Assessment (VFA) screening) or nonvertebral fractures
- 0
Original publication
Bisphosphonates Maintain BMD After Sequential Teriparatide and Denosumab in Premenopausal Women with Idiopathic Osteoporosis. J Clin Endocrinol Metab. Published 12 April 2024. doi:10.
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