Introduction Rapid descent in bone mineral density (BMD) and ascent in bone turnover marker (BTM) occur within the short period following denosumab (Dmab) discontinuation In addition, the incidence of vertebral fracture also rises within the short period The purpose of this study is to investigate the effects of sequential therapy using zoledronic acid (ZOL) on any adverse events after Dmab discontinuation Materials and methods This study was a multicenter retrospective observational study, and the subjects were osteoporosis patients who visited our institutions between 2013 and 2018 We performed sequential therapy using ZOL for 30 patients who had difficulty continuing Dmab, due to physical or social reasons, and investigated the fracture incidence and BMD/ BTM changes at 4 time points (at the start of Dmab, the start of ZOL, 6 months after ZOL and 12 months after ZOL) Results No new vertebral/nonvertebral fractures were observed at each time point after switching from Dmab to ZOL in any of the 30 patients The BMD/BTM changes were evaluated in 18 of the 30 cases, since all data of lumbar/femoral neck BMDs and TRACP-5b at 4 time points was only available in 18 cases BMDs significantly increased at each time point compared with that at the start of Dmab Serum TRACP-5b significantly decreased at each time point compared with that at the start of Dmab Conclusion It was suggested that sequential therapy using ZOL could suppress the decrease of BMD, and increase of BTM, if the period of Dmab administration was less than 3 years

中文翻译：

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管理全球危机的不确定后果：中小企业遇到逆境，损失和新机遇

简介地诺单抗（Dmab）停用后短时间内，骨矿物质密度（BMD）和骨转换指标（BTM）迅速下降。此外，椎骨骨折的发生率也在短期内上升。调查唑来膦酸（ZOL）序贯治疗对停药后任何不良事件的影响材料和方法本研究是一项多中心回顾性观察性研究，受试者为2013年至2018年间访问我们机构的骨质疏松患者。对因身体或社会原因而难以持续进行Dmab的30例患者使用ZOL，并在4个时间点（在Dmab开始，ZOL开始，结果ZOL后6个月和ZOL后12个月）结果30例患者中的任何一个在从Dmab改用ZOL后的每个时间点均未观察到新的椎体/非椎体骨折。在30例患者中，有18例评估了BMD / BTM变化，因为仅在4个时间点的所有腰/股骨颈BMD和TRACP-5b数据在18个病例中比在Dmab开始时每个时间点显着增加的BMDs血清TRACP-5b在每个时间点均显着下降结论：如果给予Dmab的时间少于3年，则ZOL序贯治疗可以抑制BMD的降低和BTM的升高。如果Dmab的管理期限少于3年如果Dmab的管理期限少于3年由于仅在18个病例中可获得4个时间点的腰/股骨BMD和TRACP-5b的所有数据，因此与每个Dmab开始时相比，每个时间点的BMD均显着增加，与每个时间点相比，血清TRACP-5b显着下降。结论：如果给予Dmab的时间少于3年，则ZOL序贯疗法可以抑制BMD的降低和BTM的升高。由于仅在18个病例中可获得4个时间点的腰/股骨BMD和TRACP-5b的所有数据，因此与每个Dmab开始时相比，每个时间点的BMD均显着增加，与每个时间点相比，血清TRACP-5b显着下降。结论：如果给予Dmab的时间少于3年，则ZOL序贯疗法可以抑制BMD的降低和BTM的升高。如果Dmab的管理期限少于3年如果Dmab的给药期限少于3年