[How to manage the rebound effect at denosumab discontinuation and avoid multiple vertebral fractures?]
Elena Gonzalez Rodriguez1,2, Olivier Lamy1,3, Bérengère Aubry-Rozier1,4
1Centre des maladies osseuses, Département de l'appareil locomoteur, CHUV, 1011 Lausanne.
Abstract:
Denosumab discontinuation is associated with a severe rebound effect combining elevation of bone remodeling markers for two years and loss of the gained bone density. In the absence of a potent bisphosphonate prescription at denosumab discontinuation, multiple vertebral fractures are frequent. The median number of vertebral fractures is 5, within 7 to 20 months (median 11) after the last denosumab injection. A potent bisphosphonate prescribed at denosumab discontinuation may reduce this risk. This strategy requires close monitoring of bone remodeling markers and adjustment of treatment if bone remodeling is not controlled.
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