Clinical effects of switching from minodronate to denosumab treatment in patients with postmenopausal osteoporosis: a retrospective study

Abstract

Background: Denosumab is a major treatment option for patients with postmenopausal osteoporosis; however, the evidence for its use is lacking. Therefore, in this 24-month retrospective study, we aimed to evaluate the effects of switching from minodronate (MIN) to denosumab in these patients. Methods: Patients with postmenopausal osteoporosis either switched from MIN to denosumab (Group 1; n = 32) or continued MIN treatment (Group 2; n = 24). Bone mineral density (BMD) of the lumbar spine (L2-L4) and femoral neck was assessed at baseline and every 6 months for 24 months. Serum bonespecific alkaline phosphatase (BAP) and N-terminal telopeptide were measured at baseline, 12 months, and 24 months. Results: Twenty-nine of the 32 patients (90.6%) in group 1 and all patients (24/24) in group 2 completed the 24-month follow-up. Switching from MIN to denosumab (Group 1) significantly increased lumbar BMD at 12, 18, and 24 months (6.1, 7.4, and 9.6%, respectively) and femoral neck BMD at 12, 18, and 24 months (2.8, 3.2, and 3.4%, respectively), whereas MIN continuous treatment (Group 2) showed no significant difference from baseline. Switching therapy also showed a significant decrease in serum BAP from baseline to 12 and 24 months (− 19.3 and − 26.5%, respectively) and serum NTX from baseline to 12 months (− 13.1%), whereas continuous MIN treatment failed to show any significant differences from baseline. Conclusion: Switching from MIN to denosumab in patients with postmenopausal osteoporosis showed clinical benefits with regard to BMD and bone turnover markers in comparison with continuous MIN treatment. It may therefore be a valid treatment option in the clinical setting.

Analysis of the subsequent treatment of osteoporosis by transitioning from bisphosphonates to denosumab, using quantitative computed tomography: A prospective cohort study

“…In the present study, the serum calcium levels did not change significantly in either group, and this is consistent with the findings of previous studies ( Nakamura et al, 2017 ; Kobayashi et al, 2020 ). However, we previously reported that a high bone turnover elevates the risk of denosumab-induced hypocalcemia ( Ishikawa et al, 2018a ; Ishikawa et al, 2016 ).…”

The effectiveness of denosumab in the treatment of postmenopausal osteoporosis: 3 years of experience in a rehabilitation center

“…In another study of patients who had used oral bisphosphonate treatment before, it was reported that denosumab achieved more significant results in total vertebrae, total hip and radius BMD scores compared to zolendronic acid (19). In another study, conducted with minodronate, which is a third generation bisphosphonate and known as the strongest bisphosphonate, more significant improvements were found in BMD and bone turnover markers in the group that switched from minodronate to denosumab treatment compared to the group that continued to use minodronate (20). In a meta-analysis of 5361 patients by Lyu et al, in which denosumab and bisphosphonates were compared, it was concluded that denosumab increased the total hip, femoral neck, and total lumbar vertebrae BMD scores more (21).…”

Effect of denosumab on renal function in women with osteoporosis evaluated using cystatin C

“…In several studies, BMD increased when switching from oral bisphosphonate to denosumab in clinical practice; however, most studies only investigated BMD in the short term or for approximately 1 year [ [25] , [26] , [27] , [28] ]. Indeed, studies conducted over a longer period (2 years or more) are scarce [ 29 , 30 ]. The increase in BMD after switching from bisphosphonate treatment to denosumab may account for the different mechanisms of action of the 2 drugs.…”