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Bone Mineral Density After Transitioning From Denosumab to Alendronate

Authors
 David Kendler  ;  Arkadi Chines  ;  Patricia Clark  ;  Peter R Ebeling  ;  Michael McClung  ;  Yumie Rhee  ;  Shuang Huang  ;  Robert Kees Stad 
Citation
 JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol.105(3) : e255-e264, 2020-03 
Journal Title
 JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 
ISSN
 0021-972X 
Issue Date
2020-03
Keywords
alendronate ; bisphosphonates ; bone mineral density ; denosumab ; osteoporosis
Abstract
Context: There are few studies on patients transitioning from denosumab to bisphosphonates. Objective: To investigate patient characteristics and changes in bone mineral density (BMD) after transitioning from denosumab to alendronate. Design: Randomized, open-label, 2-year crossover Denosumab Adherence Preference Satisfaction (DAPS) study (NCT00518531). Setting: 25 study centers in the US and Canada. Patients: Treatment-naïve postmenopausal women with BMD T-scores from -2.0 to -4.0. Interventions: This post hoc analysis evaluated women randomized to subcutaneous denosumab 60 mg every 6 months in year 1 followed by once-weekly oral alendronate 70 mg in year 2. Main outcome measure: A 3% BMD threshold identified participants who lost, maintained, or gained BMD in year 2 on alendronate. Results: Of 126 participants randomized to denosumab, 115 (91%) transitioned to alendronate in year 2. BMD increased by 3% to 6% with denosumab in year 1 and by 0% to 1% with alendronate in year 2. After transitioning to alendronate, most participants maintained or increased BMD; 15.9%, 7.6%, and 21.7% lost BMD at the lumbar spine, total hip, and femoral neck, respectively. Few participants fell below their pretreatment baseline BMD value; this occurred most often in those who lost BMD in year 2. Women who lost BMD with alendronate in year 2 also showed a greater percent change in BMD with denosumab in year 1. The BMD change in year 2 was similar regardless of baseline characteristics or adherence to oral alendronate. Conclusion: Alendronate can effectively maintain the BMD gains accrued after 1 year of denosumab in most patients, regardless of baseline characteristics.
Files in This Item:
T202001199.pdf Download
DOI
10.1210/clinem/dgz095
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176029
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