Effect of denosumab on osteolytic lesion activity after total hip arthroplasty: a single-centre, randomised, double-blind, placebo-controlled, proof of concept trial

Mahatma, Mohit M; Jayasuriya, Raveen L; Hughes, D. E.; Hoggard, Nigel; Buckley, S; Gordon, Andrew C.; Hamer, A. J.; Tomouk, Mohammed W; Kerry, R. M.; Eastell, Richard; Wilkinson, J. Mark

doi:10.1016/s2665-9913(20)30394-5

Cited by 8 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Denosumab persistently preserves the periprosthetic BMD after uncemented total hip arthroplasty 15 . In a 6-year-long study, where patients were scheduled for revision surgery for symptomatic osteolysis, it was seen that there were 83% fewer osteoclasts at the osteolysis membrane-bone interface in the denosumab group 23 .…”

Section: Joint Replacement Therapy and Denosumabmentioning

confidence: 99%

From Evidence to Practice: Denosumab in Osteoporosis and Joint Health

Dr SANJAY AGARWALA,,

Dr NIRAD VENGSARKAR,,

Dr HEMANT BHANDARI,

et al. 2024

IJCP

View full text Add to dashboard Cite

Osteoporosis and osteopenia are prevalent conditions in India, particularly among postmenopausal women and the elderly,leading to increased fracture risks and morbidity. Denosumab, a monoclonal antibody, demonstrates superior efficacyover other treatments in reducing fracture risk and enhancing bone mineral density (BMD). Clinical trials highlight itseffectiveness in preventing periprosthetic bone loss, improving implant stability, and mitigating femoral head collapse invarious conditions; combination therapies involving denosumab further amplify BMD gains and reduce fracture risk. Thearticle reviews the efficacy and safety of denosumab in managing osteoporosis, joint replacement therapy, and avascularnecrosis based on a review of clinical evidence and studies. Denosumab emerges as a cornerstone therapy for osteoporosismanagement, offering multifaceted benefits in fracture prevention, joint replacement therapy, and avascular necrosis.

show abstract

Section: Joint Replacement Therapy and Denosumabmentioning

confidence: 99%

From Evidence to Practice: Denosumab in Osteoporosis and Joint Health

Dr SANJAY AGARWALA,,

Dr NIRAD VENGSARKAR,,

Dr HEMANT BHANDARI,

et al. 2024

IJCP

View full text Add to dashboard Cite

show abstract

“…Twenty-two patients were randomized to treatment with a single dose of subcutaneous denosumab versus placebo prior to their revision THA for osteolysis. Bone surface biopsies were taken 8 weeks later at the time of surgery, with a significant decrease (83%) in osteoclast number at the bone-implant interface, as well as osteoclast surface percentage, osteoblast number, and osteoblast surface percentage in the denosumab group when compared to controls [ 77 ]. This is the first study to confirm the immunologic basis for clinical efficacy of anti-RANKL antibodies in the reduction in osteolytic activity in human subjects.…”

Section: Therapeutic Targets Of Aseptic Loosening Through Modulation ...mentioning

confidence: 99%

The Role of the Innate Immune System in Wear Debris-Induced Inflammatory Peri-Implant Osteolysis in Total Joint Arthroplasty

et al. 2022

View full text Add to dashboard Cite

Periprosthetic osteolysis remains a leading complication of total hip and knee arthroplasty, often resulting in aseptic loosening of the implant and necessitating revision surgery. Wear-induced particulate debris is the main cause initiating this destructive process. The purpose of this article is to review recent advances in understanding of how wear debris causes osteolysis, and emergent strategies for the avoidance and treatment of this disease. A strong activator of the peri-implant innate immune this debris-induced inflammatory cascade is dictated by macrophage secretion of TNF-α, IL-1, IL-6, and IL-8, and PGE2, leading to peri-implant bone resorption through activation of osteoclasts and inhibition of osteoblasts through several mechanisms, including the RANK/RANKL/OPG pathway. Therapeutic agents against proinflammatory mediators, such as those targeting tumor necrosis factor (TNF), osteoclasts, and sclerostin, have shown promise in reducing peri-implant osteolysis in vitro and in vivo; however, radiographic changes and clinical diagnosis often lag considerably behind the initiation of osteolysis, making timely treatment difficult. Considerable efforts are underway to develop such diagnostic tools, therapies, and identify novel targets for therapeutic intervention.

show abstract

“…We thank Tiwari and Tiwari for their interest in our article, 1 and for their assessment of the value of our findings for the development of a non-surgical treatment for osteolysis after joint replacement. With respect to their itemised queries, we have the following observations:…”

mentioning

confidence: 92%