Premium
Protective Effect of Denosumab on Bone in Older Women with Primary Hyperparathyroidism
Author(s) -
EllerVainicher Cristina,
Palmieri Serena,
Cairoli Elisa,
Goggi Giovanni,
Scillitani Alfredo,
Arosio Maura,
Falchetti Alberto,
Chiodini Iacopo
Publication year - 2018
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15250
Subject(s) - medicine , osteoporosis , femoral neck , bone mineral , denosumab , primary hyperparathyroidism , bone remodeling , bone density , urology , body mass index , parathyroid hormone , vitamin d and neurology , calcium
Objectives To determine the effect of denosumab, which is used in primary osteoporosis ( PO ), in primary hyperparathyroidism ( PHPT )‐related osteoporosis. Design Retrospective, longitudinal study. Setting Outpatient osteoporosis clinic. Participants Older women with PHPT (78.6 ± 5.5) (n = 25) and PO (78.8 ± 5.2) (n = 25) matched on age, body mass index, familial history of hip fracture, femoral bone mineral density ( BMD ), and personal history of fragility fractures. Intervention Twenty‐four months of denosumab therapy. Measurements We assessed the calcium‐phosphorus metabolism parameters; BMD at the lumbar spine ( LS ), femoral neck ( FN ), and total hip ( TH ) using dual X‐ray absorptiometry; and morphometric vertebral fractures using radiographs in all subjects at baseline and after 24 months. Changes in BMD and total alkaline phosphatase ( ALP ) activity were considered significant if they were greater than the least significant change ( LS 2.8%, FN 5.9%, TH 4.8%, ALP –22%) and were expressed as percentage difference between end of follow‐up and baseline (Δ). Results After 24 months, women with PHPT had greater Δ ALP (−30.6 ± 11.3), Δ FN (5.6 ± 4.8), and Δ TH (4.8 ± 4.4) than those with PO (Δ ALP −21.4 ± 13.1, Δ FN 2.9 ± 4.8, Δ TH 1.2 ± 4.1, P < .05 for all comparisons). A significant increase in BMD was more frequent in women with PHPT (92%) than in those with PO (52%, P < .05) and it was 13.4 times as likely in women with PHPT as in those with PO ( P = .02), regardless of possible confounders. Two subjects in each group had an incident fracture. Conclusions Denosumab therapy is effective in older women with PHPT ‐related osteoporosis.