A retrospective chart review was conducted on 85 renal transplant patients aged 19-88 years, treated with denosumab or bisphosphonate therapy. Bone densitometry measures were compared between treatment groups at baseline; at years 1, 2, and 3; and at final follow-up (average of 3.4 years). Both bisphosphonate and denosumab treatments increased lumbar spine bone density; however, the effect of denosumab was greater compared with that of bisphosphonate treatment. Denosumab treatment increased femoral neck BMD, whereas bisphosphonate treatment had a mean decrease in femoral neck BMD at final follow-up. Thus, our study provides evidence for the efficacy of denosumab treatment in renal transplant patients. Caution around hypocalcemia is warranted. We recommend more prospective studies to analyze the effects of long-term antiresorptive therapy in patients with a renal transplant. INTRODUCTION To compare the clinical effectiveness and safety between the use of denosumab and bisphosphonates on bone density and incidence of adverse events in renal transplant patients. METHODS A retrospective chart review was conducted on 85 renal transplant patients aged 19-88 years, treated with denosumab or bisphosphonate therapy. Bone densitometry measures were compared between treatment groups at baseline; years 1, 2, and 3; and at final follow-up (average of 3.4 years). RESULTS Absolute change in lumbar spine and femoral neck BMD over the treatment period was 0.029 ± 0.075 g/cm2 and - 0.003 ± 0.064 g/cm2, respectively, in the bisphosphonate group. Absolute change in lumbar spine and femoral neck BMD at final follow-up was 0.072 ± 0.094 g/cm2 and 0.025 ± 0.063 g/cm2, respectively, in the denosumab group. Denosumab resulted in significantly greater increases in lumbar spine BMD (0.045 g/cm2 greater in the denosumab group). Similarly, the absolute change in BMD at the femoral neck was 0.022 g/cm2 greater in the denosumab group as compared with the bisphosphonate group. The denosumab group had one event of severe hypocalcemia following first injection and one report of hospitalized pneumonia. No serious adverse events were reported in the bisphosphonate group. CONCLUSIONS Both treatments increased lumbar spine BMD; however, the effect of denosumab was greater compared with that of bisphosphonate treatment. Our study provides evidence for the efficacy of denosumab treatment in renal transplant patients. Caution around hypocalcemia is warranted. We recommend more prospective studies to analyze the effects of long-term antiresorptive therapy in patients with a renal transplant.

中文翻译：

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地诺单抗和双膦酸盐在肾移植患者中的临床疗效和安全性比较。

回顾性分析了85例年龄在19-88岁的肾移植患者，他们接受地诺单抗或双膦酸盐治疗。在基线时比较各治疗组之间的骨密度测量值；在第一年，第二年和第三年；最后一次随访（平均3.4年）。双膦酸盐和地诺单抗治疗均可增加腰椎骨密度。但是，地诺单抗的治疗效果优于双膦酸盐治疗。Denosumab治疗可增加股骨颈BMD，而双膦酸盐治疗在最终随访中平均可降低股骨颈BMD。因此，我们的研究提供了地诺单抗治疗肾移植患者疗效的证据。必须注意预防血钙过低。我们建议进行更多前瞻性研究，以分析长期抗吸收治疗对肾移植患者的影响。简介比较地诺单抗和双膦酸盐对肾移植患者的骨密度和不良反应发生率的临床有效性和安全性。方法对85例年龄在19-88岁的肾移植患者进行地诺单抗或双膦酸盐治疗。在基线时比较各治疗组之间的骨密度测量值；第1、2和3年；最后一次随访（平均3.4年）。结果在双膦酸盐治疗组中，腰椎和股骨颈骨密度在治疗期间的绝对变化分别为0.029±0.075 g / cm2和-0.003±0.064 g / cm2。denosumab组最终随访时腰椎和股骨颈BMD的绝对变化分别为0.072±0.094 g / cm2和0.025±0.063 g / cm2。Denosumab导致腰椎BMD显着增加（denosumab组增加0.045 g / cm2）。同样，地诺单抗组与双膦酸酯组相比，股骨颈BMD的绝对变化大0.022 g / cm2。denosumab组在首次注射后发生了一次严重的低血钙事件，并报告了住院的肺炎。双膦酸酯组未报告严重不良事件。结论两种治疗方法均可增加腰椎骨密度。但是，地诺单抗的治疗效果优于双膦酸盐治疗。我们的研究提供了地诺单抗治疗肾移植患者疗效的证据。必须注意预防血钙过低。我们建议进行更多的前瞻性研究，以分析长期抗吸收治疗对肾移植患者的影响。