Arthritis & rheumatology (Hoboken, N.J.) · 2026
Romosozumab and Denosumab Combination Therapy After Denosumab in Postmenopausal Osteoporosis.
СтатьяНазвание и аннотация: Перевод в очереди
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Adami Giovanni, Pollastri Francesco, Fassio Angelo, Montanari Filippo, Piccinelli Anna, Benini Camilla, Pasetto Emma, Dartizio Carmen, Gatti Davide, Rossini Maurizio, Viapiana Ombretta
Аннотация
OBJECTIVE: Transition from long-term denosumab (Dmab) to parathyroid hormone-analogs or romosozumab (Romo) might expose patients to the risk of the so-called rebound phenomenon. Adding Romo to Dmab might represent an option in patients experiencing a fracture while on Dmab. The aim of this study was to investigate the effects of the combination of Romo to Dmab in postmenopausal osteoporosis.
METHODS: We did a 36-month combined retrospective and prospective study analyzed with prospective score matching. Postmenopausal women were divided into two groups: patients on Dmab who added Romo to Dmab (Dmab from baseline [M-24] to Romo initiation [M0] ➔ Dmab + Romo from M0 to M+12), and matched controls on Dmab continuing Dmab (Dmab from M-24 to M0 ➔ Dmab from M0 to M+12). Bone mineral density and bone turnover markers (CTX, P1nP) were assessed at follow-up time points.
RESULTS: A total of 50 women were included in the study: 25 patients in the Dmab ➔ Dmab + Romo group and 25 matched controls in the Dmab ➔ Dmab group. The between-group difference at M+12 was 3.3% (95% confidence interval -5.2 to 11.8), indicating a nonsignificant trend toward greater improvement with combination therapy. Adding Romo to Dmab increased P1nP significantly between M0 and M+3 (+22.5 ng/mL, SE = 8.7; P = 0.028).
CONCLUSION: Ongoing treatment with Dmab did not blunt the anabolic response of Romo, indicating sustained modeling-based bone formation activity. Adding Romo in patients failing Dmab might be a valuable option.
METHODS: We did a 36-month combined retrospective and prospective study analyzed with prospective score matching. Postmenopausal women were divided into two groups: patients on Dmab who added Romo to Dmab (Dmab from baseline [M-24] to Romo initiation [M0] ➔ Dmab + Romo from M0 to M+12), and matched controls on Dmab continuing Dmab (Dmab from M-24 to M0 ➔ Dmab from M0 to M+12). Bone mineral density and bone turnover markers (CTX, P1nP) were assessed at follow-up time points.
RESULTS: A total of 50 women were included in the study: 25 patients in the Dmab ➔ Dmab + Romo group and 25 matched controls in the Dmab ➔ Dmab group. The between-group difference at M+12 was 3.3% (95% confidence interval -5.2 to 11.8), indicating a nonsignificant trend toward greater improvement with combination therapy. Adding Romo to Dmab increased P1nP significantly between M0 and M+3 (+22.5 ng/mL, SE = 8.7; P = 0.028).
CONCLUSION: Ongoing treatment with Dmab did not blunt the anabolic response of Romo, indicating sustained modeling-based bone formation activity. Adding Romo in patients failing Dmab might be a valuable option.