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Denosumab for the Treatment of Mastocytosis-Related Osteoporosis: A Case Series

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Abstract

The purpose of this study was to investigate the therapeutic effect of denosumab, an anti-RANKL monoclonal antibody for the treatment of bone loss in indolent systemic mastocytosis (ISM) patients intolerant to bisphosphonates. Four patients underwent upon informed consent a treatment with denosumab 60 mg administered subcutaneously every 6 months with the same regimen used for postmenopausal osteoporosis. Bone mineral density (BMD) was measured at lumbar and femoral sites at baseline and after 1 year. C-terminal telopeptide of collagen type I (CTX), bone alkaline phosphatase (bALP) and tryptase serum level were determined at baseline and after 12 months with fasting blood samples withdrawals. BMD increased significantly at both sites during the 12 months; all the patients had an important decrease of serum CTX and of lesser extent of bALP serum levels. After denosumab treatment, a decrease in serum tryptase level was observed in all the patients. No adverse events or new fractures occurred. Denosumab seems to be a valid alternative for the treatment of bone loss in ISM. RANKL might be of key importance in the pathogenesis of ISM bone involvement.

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Acknowledgements

The authors thank Sara Rossini who provided editorial assistance.

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Authors and Affiliations

  1. Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy

    Giovanni Orsolini, Irene Gavioli, Gaia Tripi, Ombretta Viapiana, Davide Gatti, Luca Idolazzi & Maurizio Rossini

  2. Hematology Section, Department of Medicine, University of Verona, Verona, Italy

    Roberta Zanotti

Authors
  1. Giovanni Orsolini
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  2. Irene Gavioli
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  3. Gaia Tripi
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  4. Ombretta Viapiana
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  5. Davide Gatti
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  6. Luca Idolazzi
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  7. Roberta Zanotti
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  8. Maurizio Rossini
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Corresponding author

Correspondence to Giovanni Orsolini.

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Conflict of interest

Giovanni Orsolini, Irene Gavioli, Gaia Tripi, Ombretta Viapiana, Davide Gatti, Luca Idolazzi, Roberta Zanotti, Maurizio Rossini declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All patients gave an informed consent to the treatment.

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Orsolini, G., Gavioli, I., Tripi, G. et al. Denosumab for the Treatment of Mastocytosis-Related Osteoporosis: A Case Series. Calcif Tissue Int 100, 595–598 (2017). https://doi.org/10.1007/s00223-017-0241-z

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  • DOI: https://doi.org/10.1007/s00223-017-0241-z

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