Effect of denosumab on bone mineral density compared with a bisphosphonate agent in glucocorticoid-induced osteoporosis

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  • Yoshii Ichiro
    Yoshii Hospital〒787-0033 高知県四万十市中村大橋通6-7-5 （6-7-5, Nakamura-Ohashidori, Shimanto city, Kochi. Zip 787-0033）E-mail: ichiroyo@giga.ocn.ne.jp

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  • ステロイド性骨粗鬆症に対するデノスマブによる骨密度への効果 －ビスホスホネート系薬剤との比較－
  • ステロイドセイ コツソショウショウ ニ タイスル デノスマブ ニ ヨル コツミツド エ ノ コウカ : ビスホスホネートケイ ヤクザイ ト ノ ヒカク

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<p>OBJECTIVE: Glucocorticoid-induced osteoporosis (GIOP) requires aggressive intervention. Generally, the first-choice drug for GIOP is a bisphosphonate (BPH); however, denosumab (dMAB) has recently become an alternative for BPH. Therefore, the aim of this study was to evaluate the effectiveness of dMAB in controlling bone mineral density (BMD) in GIOP treatment compared to that of BPH.</p><p>METHODS: Patients who met the indication criteria for GIOP, as provided in the Guidelines on the Management and Treatment of Glucocorticoid-induced Osteoporosis of the Japanese Society for Bone and Mineral Research: 2014 update, were enrolled in this study. Patients’ BMD at glucocorticoid steroid (GC) administration, 6 months after initial treatment, if the drug was changed, and 6 months after the second treatment were measured for the lumbar spine (LS), femoral neck (FN), and greater trochanter (GT) using dual-energy X-ray absorptiometry (DEXA). Patients were classified as follows based on drugs used for initial treatment and second drug, if administered: patients who had been administered no drug (N), BPH as treatment-naïve and maintained the regimen (BB), BPH as treatment-naïve and then switched to dMAB (BD), dMAB as treatment-naïve and maintained the regimen (DD), and dMAB as treatment-naïve and then switched to BPH (DB). Patients’ BMD and the associated gain at each measurement were compared statistically.</p><p>RESULTS: We recruited 149 patients (48, 24, 22, 21, and 34, in the N, BB, BD, DD, and DB groups, respectively). All groups with drug interventions but the BD group showed significant increases in BMD of the LS from baseline to the 6-month measurement. The BMD of the FN increased 6 months after the drug switch for the BD group.</p><p>DISCUSSION: dMAB demonstrated a similar effect on BMD gain as BPH.</p><p>CONCLUSION: dMAB could be chosen as an initial drug for GIOP treatment.</p>

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