Low-Dose Denosumab May Be Effective in Maintaining BMD in Postmenopausal Osteoporosis

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Researchers evaluated the efficacy of low-dose denosumab for maintaining bone mineral density in postmenopausal women with osteoporosis.

After careful consideration, the Endocrine Society canceled its annual meeting (ENDO 2020), which was set to take place in San Francisco, California, from March 28 to 31, 2020, because of concerns regarding coronavirus disease 2019 (COVID-19). Research findings that were scheduled to be presented at the meeting have been published in a supplemental issue of the Journal of the Endocrine Society.

The society is hosting ENDO Online, a complimentary virtual event featuring on-demand and live programming, from June 8 to 22, 2020, to provide a platform for continued learning and research exhibition. For more information, visit the Endocrine Society’s website.

Low-dose denosumab may be effective for maintaining bone mineral density (BMD) in postmenopausal women with osteoporosis with moderate fracture risk, according to study results intended to be presented at the annual meeting of the Endocrine Society (ENDO 2020). Researchers also noted that low-dose denosumab may be beneficial in patients with osteoporosis who are reluctant to consider full-dose denosumab because of potential adverse events.

To evaluate the efficacy of low-dose denosumab in postmenopausal osteoporosis, researchers collected data from postmenopausal women with a BMD T-score ≤-2.5 at the lumbar spine or total hip who received denosumab (30 mg/6 mo). Patients with an additional skeletal disorder or a history of a fragility fracture and patients who had received oral steroids in the prior 12 months were excluded from the study. The primary end point was change in BMD at the lumbar spine, total hip, femoral neck, and one-third distal radius at 12 months. Secondary end points included change in BMD at these 4 skeletal sites at 24 months and adverse events.

Of the 183 patients (mean age, 69±7.07 years) enrolled in the study, 80% had moderate fracture risk, 9% consumed alcohol daily, and 3% were current smokers. A total of 14.4% and 9.6% of patients were receiving selective serotonin reuptake or serotonin and norepinephrine reuptake inhibitors and proton-pump inhibitors, respectively; no patients were receiving aromatase inhibitors. In 125 patients, mean BMD significantly increased by 2.0% (95% CI, 2.8-1.3; P <.001) at the lumbar spine at 12 months. At 24 months, BMD change in 65 patients was 3.4% (95% CI, 4.8-2.0; P <.001), 1.5% (95% CI, 2.9-0.15; P =.031), and 1.9% (95% CI, 3.5-0.24; P =.025) at the lumbar spine, femoral neck, and one-third distal radius, respectively.

Overall, low-dose denosumab was found to be effective in maintaining BMD in postmenopausal women with moderate fracture risk, with benefits extending to patients experiencing adverse events or with concerns about potential adverse events.

“[Low-dose denosumab] may also be of value following 10 years of therapy in order to maintain BMD,” the researchers concluded.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Khan AA, Alrob HA, M’Hiri I, et al. Efficacy of low dose denosumab in maintaining bone mineral density in postmenopausal women with osteoporosis: a real world, prospective observational study. J Endocr Soc. 2020;4(suppl 1):SUN-377.

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This article originally appeared on Endocrinology Advisor