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Endocrine Abstracts (2018) 56 GP59 | DOI: 10.1530/endoabs.56.GP59

ECE2018 Guided Posters Bone and Osteoporosis (10 abstracts)

Thirty-one men and women with145 spontaneous vertebral fractures after denosumab discontinuation: a single center observational study

Gonzalez Rodriguez Elena 1, , Delphine St 2 , Bérengère Aubry-Rozier 2 & Lamy Olivier 2,


1Service of Endocrinology, Diabetes and Metabolism, CHUV, Lausanne, Switzerland; 2Center of Bone Diseases, CHUV, Lausanne, Switzerland; 3Service of Internal Medicine, CHUV, Lausanne, Switzerland.


Denosumab discontinuation (DD) induces an increase of B-crosslaps above baseline values for two years, and a decrease of BMD values. This rebound effect is associated with spontaneous clinical vertebral fractures (SCVF) in close to 15% of patients considering a follow-up of 2 years without taking another osteoporosis treatment. We report the clinical characteristics of 31 patients evaluated at our center from July 2015 to January 2018.

Results: Thirty women and one man, 62.8±10.1 years, experienced 145 SCVF (median 5) in the 11.7±3.0 months (median 11; min 7, max 20) following the last denosumab injection. They received 6.4±2.7 denosumab injection (min 2; max 11). Ten women had vertebroplasties with 22 new SCVF in the following days. Nine women received aromatase-inhibitors (AI) with denosumab. Eight women had prevalent VF, five received bisphosphonate before denosumab. The mean B-crosslaps value at the time of SCVF was 1511±573 μg/l; B-crosslaps values increase with the number of denosumab doses (P=0.05) and decrease with age (P<0.01). The number of SCVF was inversely associated with age (P<0.004). Before the vertebroplasty, the mean number of SCVF was 5.1±3.0 vs 2.3±1.5 in women <65 vs >65 years. The delay between DD and the occurrence of SCVF increases with age: 10.6±1.6 vs 13.3±3.8 months, before vs after 65 years (P<0.01). The mean reasons for DD were: end of AI or no more osteoporosis (15), omission (7), patient’s wish (5), AFF or dental intervention (4).

Conclusion: The SCVF are a very severe and frequent clinical complication occurring after DD. A close follow-up during 2 years post DD is necessary. Studies are urgently needed to better define the place of denosumab in osteoporosis treatment, and the strategies to avoid these side effects.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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