Endocrine Abstracts

Denosumab is a monoclonal antibody against RANKL used in the treatment of postmenopausal osteoporosis. RANK/RANKL/OPG cycle is effective on both immune system and osteoporosis. Some RANK mutations are associated with hypogammaglobulinaemia. There are studies suggesting that the RANK/RANKL pathway may mediate the development of insulin resistance and hepatosteatosis. However, the clinical effects of denosumab on inflammation and immunity are not well known. In this study, we aimed to investigate the effects of denosumab treatment on metabolic and inflammatory parameters. In our study, 30 patients who were over 50 years of age, had been in menopause for at least one year, had a lumbar vertebra or hip T score of -2.5 or below in bone mineral density measurement, or had a history of fragility fracture, and were unable to use or did not respond to other treatments, who applied to the outpatient clinics or were followed up in the wards of our hospital between November 2021 and March 2023 were included. Patients received 60 mg subcutaneous denosumab and standard doses of calcium and vitamin supplementation (1g elemental calcium + 880IU vitamin D3). Complete blood count, neutrophil/lymphocyte ratio, erithrocyte sedimentation rate (ESR), CRP, fibrinogen, ferritin, procalcitonin, D-dimer, homocysteine, fasting blood glucose, insulin, HOMA-IR, LDL, HDL, triglyceride, lipoprotein (a), calcium, albumin, phosphorus, parathormone, alkaline phosphatase parameters were evaluated retrospectively before and 1 month after treatment. In our study, no significant difference was found between the metabolic parameters analysed before and after denosumab administration (P>0.05). A significant decrease was found in calcium (P=0.003), phosphorus (P<0.001) and albumin (P=0.005) levels. A statistically significant increase was found in parathormone levels (P<0.001). Leukocyte (P=0,042), neutrophil (P=0,042) and monocyte (P=0,034) values before and after denosumab treatment showed a significant decrease. In our study, it was found that short term denosumab treatment had no effect on metabolic parameters. But it has been shown that it may have an effect on immune system responses and inflammation by reducing nerutrophil and monocyte levels.