JAMA Netw Open
Zoledronate following denosumab discontinuation: Does it prevent BMD loss?
Sequential therapy with zoledronate failed to prevent loss of bone mineral density in the lumbar spine (LS-BMD) in the first year after discontinuing denosumab, compared with continuous denosumab treatment. Longer duration of denosumab treatment (prior to discontinuation) was associated with a further decrease in LS-BMD after zoledronate sequential therapy. Authors call for further randomized trials and large-scale studies to evaluate strategies of sequential therapy after long-term denosumab treatment.
The Denosumab Sequential Therapy prospective, open-label, parallel-group randomized trial included postmenopausal women and men ≥50 years of age who received regular denosumab treatment for ≥2 years and didn’t have previous exposure to other antiosteoporosis medication. Participants were assigned to 1 of 2 groups: group A received continuous denosumab treatment (60 mg twice yearly) as the positive control, and group ZOL received 1 dose of zoledronate (5 mg) in the first year.
The study included 101 patients (94.1% women; median age, 72.0 years): 25 patients (92.0% women; median age, 74.0 years) in group A and 76 (94.7% women; median age, 71.0 years) in group ZOL. Group ZOL had a significant median decrease in LS-BMD in the first year (-0.68%) compared with group A (1.30%). No significant between-group differences were observed in total hip BMD and femoral neck BMD. A significant difference in median LS-BMD percentage change was observed in the ZOL subgroup with ≥3 years of denosumab treatment before enrollment (-3.20%) compared with group A (1.30%).
Source:
Lee CC, et al. (2024, November 11). JAMA Netw Open. Zoledronate Sequential Therapy After Denosumab Discontinuation to Prevent Bone Mineral Density Reduction: A Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/39527056/