Certainties and Uncertainties About Denosumab Discontinuation
The subjects of optimal duration of osteoporosis treatment and consequences of stopping osteoporosis drugs have gained significant attention lately. The larger amount of data derives from the use of bisphosphonates, due to their longer existence in the armamentarium of osteoporosis therapy. It is an unequivocal fact that bisphosphonates, especially those with a greater binding affinity to hydroxyapatite such as alendronate and zoledronic acid, display a sustained effect on bone metabolism after their discontinuation. This effect is mirrored in a stabilization or very gradual decrease of bone mineral density (BMD) and a slow return of bone turnover markers (BTMs) towards baseline after cessation of bisphosphonate treatment [1, 2]. In this respect, bisphosphonates constitute an exception in the field of anti-osteoporosis drugs, since all other therapeutic agents have no persistent long-term effects on bone turnover after their discontinuation, as has been shown for estrogen replacement...
This work was supported by the MedDrive Starting Grant of TU Dresden to ET.
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Conflict of interest
Elena Tsourdi reported honoraria for lectures from Amgen. Carola Zillikens has received fees for lectures and participation in advisory boards from Amgen and Eli Lilly.
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