TY - JOUR

T1 - Treatment of osteoporosis with denosumab in patients with decreased kidney function

AU - Svendsen, Ole Lander

N1 - Funding Information: Sofie Truong, medical student, collected the data, and Rama Fartous, MD, made a first draft of the manuscript. Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

N2 - Introduction: Little is known about treatment of osteoporosis with denosumab (Prolia®) in patients with decreased kidney function. The aim of this retrospective case report study was to investigate effects and side-effects of such treatment. Methods: Since 2012, 75 patients with osteoporosis and decreased kidney function had been treated with denosumab (Prolia®) in the osteoporosis outpatient clinic of the department of endocrinology, Bispebjerg Hospital, University of Copenhagen, Denmark, and data were retrospectively collected from the patient records of these patients in 2021. Results: At baseline, the mean estimated glomerular filtration rate (eGFR) was 34 mL/min (range 9–50) and the median age was 85 years (range 45–103). 95% of the patients had had low-energy fractures, and the bone mineral density T score of the hips was on average − 2.7. All, but one, patients had normal/high parathyroid hormone (PTH) levels. The mean duration of the treatment with denosumab at the follow-up was 5.3 years (range 1.5–10). There was an annual increase of 12% and of 7% in the T score of in the lumbar spine and hip, respectively, compared to the T-scores prior to the denosumab treatment. 20% had a new fracture during the follow-up. 21% had biochemical hypocalcemia following denosumab injection, 7% developed symptoms of hypocalcemia, whereas 4% needed to be hospitalized acutely. Conclusion: Treatment with denosumab of osteoporosis in patients with decreased kidney function (eGFR 9–50 mL/min), with normal/high PTH, seems in general to be well tolerated, with improvement of bone and decreased risk of new fractures.

AB - Introduction: Little is known about treatment of osteoporosis with denosumab (Prolia®) in patients with decreased kidney function. The aim of this retrospective case report study was to investigate effects and side-effects of such treatment. Methods: Since 2012, 75 patients with osteoporosis and decreased kidney function had been treated with denosumab (Prolia®) in the osteoporosis outpatient clinic of the department of endocrinology, Bispebjerg Hospital, University of Copenhagen, Denmark, and data were retrospectively collected from the patient records of these patients in 2021. Results: At baseline, the mean estimated glomerular filtration rate (eGFR) was 34 mL/min (range 9–50) and the median age was 85 years (range 45–103). 95% of the patients had had low-energy fractures, and the bone mineral density T score of the hips was on average − 2.7. All, but one, patients had normal/high parathyroid hormone (PTH) levels. The mean duration of the treatment with denosumab at the follow-up was 5.3 years (range 1.5–10). There was an annual increase of 12% and of 7% in the T score of in the lumbar spine and hip, respectively, compared to the T-scores prior to the denosumab treatment. 20% had a new fracture during the follow-up. 21% had biochemical hypocalcemia following denosumab injection, 7% developed symptoms of hypocalcemia, whereas 4% needed to be hospitalized acutely. Conclusion: Treatment with denosumab of osteoporosis in patients with decreased kidney function (eGFR 9–50 mL/min), with normal/high PTH, seems in general to be well tolerated, with improvement of bone and decreased risk of new fractures.

KW - Chronic kidney disease

KW - Decreased kidney function

KW - Denosumab

KW - Fractures

KW - Osteoporosis

U2 - 10.1007/s11657-023-01306-x

DO - 10.1007/s11657-023-01306-x

M3 - Journal article

C2 - 37495795

AN - SCOPUS:85165919157

VL - 18

JO - Archives of Osteoporosis

JF - Archives of Osteoporosis

SN - 1862-3522

IS - 1

M1 - 104

ER -