Changes in RANKL and TRAcP 5b after discontinuation of denosumab suggest RANKL mediated formation of osteoclasts results in the increased bone resorption
Authors' conclusion
Following discontinuation of long-term DMAB, we find high levels of RANKL, which most likely result in an increase in the number of active osteoclasts (illustrated by TRAcP5b) causing an increased bone turnover.
Study context
- Population
- Patients with BMD T-score > - 2.5 at the spine and hip discontinuing long-term denosumab
- Participants
- 61 patients
- Comparison
- Zoledronate 6 months vs 9 months vs 12 months (or when bone turnover high) after the last denosumab injection
- 6 Mn = 20reference
- 9 Mn = 20
- 12 Mn = 21
- Primary endpoint
- Bone turnover markers (TRAcP 5b, RANKL, OPG, CTX, P1NP) measured immediately before initiation of ZOL
Primary result
As reported in the abstract
Bone turnover markers before ZOL
- TRAcP 5b correlated negatively with RANKL, R
- - 0.54
- Time since last denosumab (DMAB) injection correlated with CTX, R
- 0.56
- Time since last DMAB injection correlated with PINP, R
- 0.72
- Time since last DMAB injection correlated with TRAcP 5b, R
- 0.51
- Time since last DMAB injection correlated with RANKL, R
- - 0.70
Original publication
Changes in RANKL and TRAcP 5b after discontinuation of denosumab suggest RANKL mediated formation of osteoclasts results in the increased bone resorption. Osteoporos Int. Published 22 December 2022. doi:10.
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