[Denosumab in clinical practice : beware before, during and after].

Abstract

Denosumab is a very effective treatment of osteoporosis, easy to use and very well tolerated. Due to some associated risks, a close clinical follow-up is necessary. Before the first injection, it is necessary to correct hypocalcaemia or vitamin D deficiency when present. Calcemia has to be followed in case of renal insufficiency. Injections of denosumab should be done scrupulously every 6 months (± 3 weeks). Discontinuation of denosumab is associated with a severe rebound effect characterized by increased markers of bone remodeling, a rapid decrease of bone density values, and a risk of multiple spontaneous vertebral fractures. The administration of a potent bisphosphonate (zoledronate, alendronate) minimises or avoids this rebound effect.

• Authors: Olivier Lamy, Elena Gonzalez-Rodriguez, Delphine Stoll, Bérengère Aubry-Rozier
• Journal: Revue medicale suisse (Rev Med Suisse) Vol. 13 Issue 559 Pg. 863-866 (Apr 19 2017) ISSN: 1660-9379 [Print] Switzerland
• Vernacular Title: Dénosumab en routine clinique: précautions à prendre avant, pendant et après.
• PMID: 28727345 (Publication Type: Journal Article)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Denosumab

Topics

• Bone Density (drug effects)
• Bone Density Conservation Agents (administration & dosage, adverse effects)
• Bone Remodeling (drug effects)
• Denosumab (administration & dosage, adverse effects)
• Diphosphonates (administration & dosage, adverse effects)
• Drug Administration Schedule
• Humans
• Hypocalcemia (complications, therapy)
• Osteoporosis (drug therapy)
• Time Factors
• Vitamin D Deficiency (complications, therapy)