Delayed Denosumab Injections and Fracture Risk
Authors: Kristine E. Ensrud, John T. Schousboe
Journal: Annals of Internal Medicine (2020)

Editorials6 October 2020Delayed Denosumab Injections and Fracture RiskKristine E. Ensrud, MD, MPH and John T. Schousboe, MD, PhDKristine E. Ensrud, MD, MPHUniversity of Minnesota and VA Health Care System, Minneapolis, Minnesota (K.E.E.)Search for more papers by this author and John T. Schousboe, MD, PhDHealthPartners Institute and University of Minnesota, Minneapolis, Minnesota (J.T.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-4802 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Social distancing strategies to mitigate transmission of severe acute respiratory syndrome coronavirus 2 have resulted in delays in management of chronic diseases, including osteoporosis. Because disruptions in the administration of osteoporosis drug treatments may be more common during the pandemic, Lyu and colleagues' article (1) examining the effect of delayed denosumab injections on fracture risk is timely and relevant to patients with osteoporosis and their clinicians.Denosumab, a biologic therapy approved for treatment of postmenopausal women and men with osteoporosis at high fracture risk, is administered by a health care professional every 6 months by subcutaneous injection. Discontinuation of denosumab ...References1. Lyu H, Yoshida K, Zhao SS, et al. Delayed denosumab injections and fracture risk among patients with osteoporosis. A population-based cohort study. . Ann Intern Med. 2020;173:516-26. [PMID: 32716706]. doi:10.7326/M20-0882 LinkGoogle Scholar2. Bone HG, Bolognese MA, Yuen CK, et al. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2011;96:972-80. [PMID: 21289258] doi:10.1210/jc.2010-1502 CrossrefMedlineGoogle Scholar3. Miller PD, Bolognese MA, Lewiecki EM, et al; Amg Bone Loss Study Group. Effect of denosumab on bone density and turnover in postmenopausal women with low bone mass after long-term continued, discontinued, and restarting of therapy: a randomized blinded phase 2 clinical trial. Bone. 2008;43:222-9. [PMID: 18539106] doi:10.1016/j.bone.2008.04.007 CrossrefMedlineGoogle Scholar4. Cummings SR, Ferrari S, Eastell R, et al. Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized placebo-controlled FREEDOM trial and its extension. J Bone Miner Res. 2018;33:190-198. [PMID: 29105841] doi:10.1002/jbmr.3337 CrossrefMedlineGoogle Scholar5. Tripto-Shkolnik L, Fund N, Rouach V, et al. Fracture incidence after denosumab discontinuation: real-world data from a large healthcare provider. Bone. 2020;130:115150. [PMID: 31715340] doi:10.1016/j.bone.2019.115150 CrossrefMedlineGoogle Scholar6. Ban JK, Hao BB, McCarthy L, et al. Denosumab utilization among older adults in Ontario: patient characteristics, persistence with therapy, and return to therapy after an extended gap. Osteoporos Int. 2019;30:1865-1872. [PMID: 31317248] doi:10.1007/s00198-019-05051-1 CrossrefMedlineGoogle Scholar7. Lyu H, Zhao SS, Yoshida K, et al. Delayed denosumab injections and bone mineral density response: an electronic health record-based study. J Clin Endocrinol Metab. 2020;105. [PMID: 31894244] doi:10.1210/clinem/dgz321 CrossrefMedlineGoogle Scholar8. Hadji P, Papaioannou N, Gielen E, et al. Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int. 2015;26:2479-89. [PMID: 26018090] doi:10.1007/s00198-015-3164-4 CrossrefMedlineGoogle Scholar9. Yu EW, Tsourdi E, Clarke BL, et al. Osteoporosis management in the era of COVID-19. J Bone Miner Res. 2020;35:1009-1013. [PMID: 32406536] doi:10.1002/jbmr.4049 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Minnesota and VA Health Care System, Minneapolis, Minnesota (K.E.E.)HealthPartners Institute and University of Minnesota, Minneapolis, Minnesota (J.T.S.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-4802.Corresponding Author: Kristine E. Ensrud, MD, MPH, Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, 1110, One Veterans Drive, Minneapolis, MN 55417; e-mail, [email protected]edu.Current Author Addresses: Dr. Ensrud: Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, 1110, One Veterans Drive, Minneapolis, MN 55417.Dr. Schousboe: HealthPartners Institute, 3311 Old Shakopee Road, Bloomington, MN 55425.This article was published at Annals.org on 28 July 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDelayed Denosumab Injections and Fracture Risk Among Patients With Osteoporosis Houchen Lyu , Kazuki Yoshida , Sizheng S. Zhao , Jie Wei , Chao Zeng , Sara K. Tedeschi , Benjamin Z. Leder , Guanghua Lei , Peifu Tang , and Daniel H. Solomon Metrics Cited byComparative Effect of Zoledronate at 6 Versus 18 Months Following Denosumab DiscontinuationProgression of Rebound-Associated Vertebral Fractures Following Denosumab Discontinuation Despite Reinstitution of Treatment: Suppressing Increased Bone Turnover May Not Be Enough 6 October 2020Volume 173, Issue 7Page: 582-583 ePublished: 28 July 2020 Issue Published: 6 October 2020 PDF downloadLoading ...