[How to manage the rebound effect at denosumab discontinuation and avoid multiple vertebral fractures?]
[How to manage the rebound effect at denosumab discontinuation and avoid multiple vertebral fractures?]
复制标题
【如何应对狄诺塞麦停药后的反弹效应，避免多发椎体骨折？】
作者：
E. Gonzalez Rodriguez;O. Lamy;B. Aubry;D. Stoll;B. Uebelhart
停用Denosumab与严重的反弹效应有关，包括两年内骨重建标记物的升高和获得的骨密度的丧失。在迪诺单抗停用时缺乏有效的双磷酸盐处方，多发性脊椎骨折是常见的。在最后一次注射地诺单抗后7至20个月内，中位数为5个椎体骨折(中位数11个)。在停用地诺单抗时开出有效的双膦酸药可能会降低这种风险。这一策略需要密切监测骨重建标志物，并在骨重建得不到控制的情况下调整治疗。
Denosumab discontinuation is associated with a severe rebound effect combining elevation of bone remodeling markers for two years and loss of the gained bone density. In the absence of a potent bisphosphonate prescription at denosumab discontinuation, multiple vertebral fractures are frequent. The median number of vertebral fractures is 5, within 7 to 20 months (median 11) after the last denosumab injection. A potent bisphosphonate prescribed at denosumab discontinuation may reduce this risk. This strategy requires close monitoring of bone remodeling markers and adjustment of treatment if bone remodeling is not controlled.