Houchen Lyu et al Recently delayed administration of subsequent denosumab doses by more than 16 weeks is associated with increased risk for vertebral fracture compared with on-time dosing
Ann Intern Med, 2020 Oct 6;173(7):516-526. doi: 10.7326/M20-0882. Epub 2020 Jul 28.
In contrast with bisphosphonates, which are long acting, discontinuing denosumab without immediately switching to a different osteoporosis medication results in rapid loss of bone mineral density and increased fracture risk. Although this emulated study was underpowered, its findings are generally consistent with those of earlier trials as well as observational and pharmacodynamic data on denosumab. Bottom line: Clinicians should facilitate timely repeat injections for patients receiving denosumab. An editorialist notes that, as a result of the COVID-19 pandemic, delayed repeat injections may be more common; thus, clinicians should consider prescribing oral bisphosphonates when patients cannot or will not return for timely repeat injections of denosumab.
