Denosumab Therapy Beyond 10 Years: Subsequent Treatment and Densitometric Outcomes
Authors' conclusion
After ≥20 doses of denosumab, most patients continued treatment, guided largely by the 20th-dose BMD T-score. Continuing denosumab beyond 10 years resulted in further increases in BMD at the lumbar spine and maintenance of BMD at the femoral neck, whereas transition to zoledronic acid led to partial loss of previous gains and transition to romosozumab increased lumbar spine BMD only.
Study context
- Population
- Patients who received ≥20 consecutive doses of DMAB at an Osteoporosis Centre, June 2012–December 2024; mean age 72.9 years, 98.1% female
- Participants
- 54 patients
- Exposure
- Continuation of DMAB vs transition to zoledronic acid or romosozumab after 20 doses
- Continued denosumabn = 48reference
- Zoledronic acidn = 4
- Romosozumabn = 2
- Outcome
- Treatment after 20 doses and subsequent BMD trajectories
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- 20th-dose BMD T-score was the major determinant of subsequent treatment: lowest T-scores → romosozumab, highest → zoledronic acid
- Continued DMAB: further BMD gains at lumbar spine and femoral neck but not total hip
- Zoledronic acid: partial loss of year-10 BMD gains
- Romosozumab: further BMD gain at lumbar spine only
- Trajectory analyses restricted to patients without delayed dosing and with BMD reassessment after the 20th dose
Observational data: associations, not effects.
Safety
- Cases of atypical femoral fracture or osteonecrosis of the jaw
- 0
Original publication
Denosumab Therapy Beyond 10 Years: Subsequent Treatment and Densitometric Outcomes. Endocr Pract. Published 3 February 2026. doi:10.
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