Denosumab discontinuation can lead to bone loss despite subsequent bisphosphonate therapy. This bone loss is more severe in patients treated with denosumab for longer than 3 years. We aimed to evaluate the bone mass changes after only a single denosumab injection followed by zoledronate administration. We screened all of our patients who received a single denosumab injection and who were included in the osteoporosis register from the Swiss Society of Rheumatology between August 1, 2010, and January 31, 2022. This case series assessed the outcome of patients who were consecutively treated with one denosumab injection followed by a single infusion of zoledronate 6 months later. Bone mineral density (BMD) and bone turnover markers (BTM) changes were analysed before therapy and 18 months later. Percentage BMD changes and T-scores were compared with those of registered patients who received 2.5 years of denosumab treatment and one subsequent infusion of zoledronate. Thirty-two patients (31 female, 1 male) received a single denosumab injection and one zoledronate infusion 6 months later. BTM decreased significantly in this period (p = 0.035). Percentage BMD changes from baseline to 1 year after zoledronate treatment were 7.6% [IQR 3.2, 9.4] at the lumbar spine, 3.5% [1.8, 5.9] at the total hip and 4.6% [1.3, 6.0] at the femoral neck. In contrast, percentage changes from baseline in 110 patients with 2.5 years of denosumab treatment and one zoledronate infusion were 5.6% [3.0, 9.1], 2.3% [0.2, 4.9] and 2.3% [−0.9, 4.7], respectively. Differences between the 2 groups were significant at the lumbar spine (p = 0.014), total hip (p = 0.010) and femoral neck (p = 0.010).

A single denosumab injection followed by zoledronate led to a remarkable gain of BMD at the lumbar spine and hip within a short time. This observation could help to identify a new short treatment sequence for patients with osteoporosis.

尽管随后进行了双膦酸盐治疗，但停用狄诺塞麦仍会导致骨质流失。这种骨质流失在接受狄诺塞麦治疗超过 3 年的患者中更为严重。我们的目的是评估仅注射一次狄诺塞麦和唑来膦酸盐后的骨量变化。我们筛选了所有接受单次狄诺塞麦注射并被纳入瑞士风湿病学会骨质疏松症登记册的患者2010 年 8 月 1 日至 2022 年 1 月 31 日之间。该病例系列评估了连续接受一次狄诺塞麦注射治疗，然后在 6 个月后单次输注唑来膦酸盐的患者的结果。在治疗前和 18 个月后分析骨矿物质密度 (BMD) 和骨转换标志物 (BTM) 的变化。将 BMD 变化百分比和 T 分数与接受 2.5 年狄诺塞麦治疗并随后输注唑来膦酸盐的注册患者进行比较。6 个月后，32 名患者（31 名女性，1 名男性）接受了一次狄诺塞麦注射和一次唑来膦酸输注。在此期间 BTM 显着下降 ( p = 0.035)。唑来膦酸治疗后从基线到 1 年的腰椎骨密度变化百分比为 7.6% [IQR 3.2, 9.4]，全髋为 3.5% [1.8, 5.9]，股骨颈为 4.6% [1.3, 6.0]。相比之下，110 名接受 2.5 年地诺单抗治疗和一次唑来膦酸输注的患者相对于基线的百分比变化分别为 5.6% [3.0, 9.1]、2.3% [0.2, 4.9] 和 2.3% [-0.9, 4.7]。两组之间的差异在腰椎（ p  = 0.014）、全髋（ p  = 0.010）和股骨颈（ p  = 0.010）有显着差异。

单次狄诺塞麦注射和唑来膦酸盐在短时间内导致腰椎和臀部的 BMD 显着增加。这一观察结果可能有助于为骨质疏松症患者确定一种新的短期治疗顺序。