Discontinuation of denosumab in men with prostate cancer
Authors' conclusion
In men with non-metastatic prostate cancer, discontinuation of DMAB after stopping ADT led to an average bone loss of 2-5%. Zoledronate prevented bone loss in men with osteopenia.
Study context
- Population
- Men with non-metastatic prostate cancer discontinuing denosumab (DMAB) after androgen deprivation therapy (ADT), referred from Urology to Endocrinology, Aarhus University Hospital, June 2018–June 2021; mean DMAB duration 5 ± 0.1 years
- Participants
- 50 men
- Exposure
- Zoledronate vs no zoledronate after DMAB discontinuation
- Zoledronaten = 9
- No zoledronaten = 24reference
- Outcome
- Change in lumbar spine BMD
- Follow-up
- Between first DXA (0–6 months after last DMAB injection) and second DXA (≈12 months later)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
between first and second DXA
No zoledronate
- 4.9
± 4.2 · %
- Significant decrease in spine BMD without zoledronate
- P ≤ 0.01
Observational data: associations, not effects.
Further findings
- Change in total hip BMD · between first and second DXA — No zoledronate
- - 1.9 ± 3.5 %
- Change in femoral neck BMD · between first and second DXA — No zoledronate
- - 2.4 ± 3.6 %
- Change in total hip BMD — Significant decrease
- p ≤ 0.01
- Change in femoral neck BMD — Significant decrease without zoledronate
- p ≤ 0.01
Change in femoral neck BMD · between first and second DXA
- Femoral neck BMD maintained with zoledronate after a mean of 16 months
Safety
Fragility fractures after DMAB discontinuation
- Patient without zoledronate with multiple fragility vertebral fractures
- 1
Original publication
Discontinuation of denosumab in men with prostate cancer. Osteoporos Int. Published 19 November 2022. doi:10.
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