Rebound-associated vertebral fractures may occur in sequential time points following denosumab discontinuation: need for prompt treatment reinitiation
Rebound-associated vertebral fractures may occur in sequential time points following denosumab discontinuation: need for prompt treatment reinitiation
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DOI：
10.1016/j.bonr.2020.100267
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发表时间：
2020-06-01
期刊：
影响因子：
2.5
通讯作者：
Iliopoulos, Alexios
中科院分区：
文献类型：
--
作者：
Anastasilakis, Athanasios D.;Evangelatos, Gerasimos;Iliopoulos, Alexios
停止使用Denosumab与反弹相关的多发性脊椎骨折的风险增加有关。我们报告了三名患者，两名女性和一名男性，他们在停药后表现出反弹相关的椎体骨折，并在几个月后持续新的椎体骨折。其中两名患者之前曾接受过双膦酸盐治疗。患者在治疗2到8年后停止使用地诺单抗。其中一名女性患者因不明原因的结缔组织疾病每天服用强的松龙7.5毫克，而男性患者因皮肌炎每天服用甲基强的松龙8毫克。我们推测，至少在某些情况下，停药后反弹相关的多发性椎体骨折可能是连续发生的，而不是同时发生的。我们的病例进一步强调了在持续反弹相关椎体骨折的患者中迅速应用有效的抗吸收药物的必要性，以便不仅防止骨丢失，而且还防止第二轮骨折。
Denosumab discontinuation has been associated with increased risk of rebound-associated multiple vertebral fractures. We report the cases of three patients, two females and one male, who had manifested rebound-associated vertebral fractures after denosumab discontinuation and sustained new vertebral fractures a few months later. Two of the patients had been previously treated with bisphosphonates. Patients discontinued denosumab after 2 to 8 years of treatment. One of the female patients was receiving prednisolone 7.5 mg daily for an unspecified connective tissue disorder and the male patient methylprednisolone 8 mg daily for dermatomyositis. We hypothesize that rebound-associated multiple vertebral fractures after denosumab discontinuation may occur, at least in some cases, sequentially instead of simultaneously. Our cases further underpin the need for prompt initiation of potent antiresorptives in patients who sustained rebound-associated vertebral fractures, in order to prevent not only bone loss but also a second round of fractures.