Abstract
Purpose Denosumab is a monoclonal antibody that prevents the development of osteoclasts. The effect of denosumab in solid organ transplant recipients has been elucidated, but its effect in haematopoietic stem cell transplantation recipients has not been studied yet. The aim of this study was to determine the effectiveness and safety of denosumab in haematopoietic stem cell transplantation recipients. Methods We retrospectively evaluated 33 female patients with osteoporosis (mean age 52.6 ± 9.8 years) following allogeneic haematopoietic stem cell transplantation. Patients were treated with denosumab every 6 months for 12 months. Changes in bone mineral density were evaluated for denosumab-treated patients in a 12-month interval after the first administration of denosumab. Results Significant increases in bone mineral density were observed in all measured skeletal sites including 4.39 ± 6.63% in the lumbar spine (p=0.014), 3.11 ± 7.69% in the femoral neck (p=0.048), and 1.97 ± 6.01% in the total hip (p=0.138). The bone turnover marker serum cross-linked C-terminal telopeptide of type 1 collagen was decreased at 18 months (−51.6 ± 17.6%, p < 0.001). No serious symptomatic hypocalcaemia was observed. Serious adverse drug reactions requiring drug discontinuation were not observed. Conclusion Denosumab improved bone mineral density in haematopoietic stem cell transplantation recipients. The use of denosumab could be a good therapeutic option without causing severe adverse effects in recipients of haematopoietic transplantation.
Highlights
Osteoporosis is a serious disease that affects more than 200 million people worldwide [1]
We retrospectively evaluated 33 postmenopausal patients with osteoporosis following allogeneic haematopoietic stem cell transplantation (HSCT)
In the present retrospective study, we analysed the results of denosumab therapy in patients after HSCT
Summary
Osteoporosis is a serious disease that affects more than 200 million people worldwide [1]. A variety of agents have been approved to treat osteoporosis. Several antiresorptive agents such as bisphosphonates (BPs), selective oestrogen receptor modulators, and denosumab have successfully decreased the incidence of new fractures by 30–50% [4, 5]. Denosumab, the first approved biologic agent for the treatment of osteoporosis, is a powerful antiresorptive drug that significantly reduces the risk of hip, vertebral, and nonvertebral fractures in patients with postmenopausal osteoporosis [6]. Advances in transplantation techniques and supportive care have led to an increase in the long-term survival following haematopoietic stem cell transplantation (HSCT), which is the treatment of choice for some malignant haematological diseases [9]. BPs are the most frequently studied drugs for the HSCT-associated loss
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