SFEBES2014 Poster Presentations Bone (30 abstracts)
An audit of the clinical indications for initiation of Denosumab as a treatment for Osteoporosis in a secondary care clinic
Angela Collie 1 , Khun Phyomaung 1 , Menai Shahim 1 , Stephen Gallacher 1 , Andrew Gallagher 2 , Fergus McLean 1 , John Ahukannah 1 & John Hinnie 2
1Southern General Hospital, Glasgow, UK; 2Victoria Infirmary Hospital, Glasgow, UK.
Objective: Denosumab is a highly specific MAB, which binds to RANK Ligand thus inhibiting osteoclast formation, function and survival1.
It’s efficacy in the treatment of osteoporosis was demonstrated in the FREEDOM trial which was an international, randomised, placebo controlled trial involving 7686 post menopausal women. The trial demonstrated a reduction in risk for vertebral fractures (68%), non vertebral fractures (20%), and hip fractures (40%)2. Denosumab was approved in 2010 for the treatment of post menopausal women with osteoporosis. This audit looks at clinical indications for which Denosumab is being prescribed in a secondary care mineral metabolism clinic.
Methods: Eighty-five patients attending a mineral metabolism clinic in secondary care were prescribed Denosumab between 12/01/12 (the date the first use of Denosumab at the clinic) and 09/10/13.The reason for prescription was categorised as i) poor outcome with previous treatment, ii) bisphosphonate intolerance, iii) eGFR <35 ml/min, iv) fracture while on ‘bishosphonate holiday’, v) patients with learning difficulties, and vi) other.
Results: The total number of patients was 85, of whom 78 were female and seven males. The mean age was 74 with an age range 43–90.The distribution between the categories was: Poor outcome with previous treatment 46%, bishosphonate intolerance 20%, eGFR<35 ml/min 18%, fracture while on ‘bisphosphonate holiday’ 6%, patients with learning difficulties 3%, and other 7%.
Conclusion: This audit illustrates the various ways in which Denosumab is being used in a secondary care mineral metabolism clinic.
References: 1. Boyle WJ et al. Nature 2003 423 337–342.
2. Cummings SR et al. New Eng J Med 2009 361 756–764.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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