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地舒单抗治疗颌骨炎停药后与反跳相关的椎体骨折。

Rebound-associated vertebral fractures after discontinuation of denosumab for the treatment of maxillitis.

机构信息

Department of Orthopaedic Surgery, Tomidahama Hospital, 26-14, Tomidahamacho, Yokkaichi City, Mie, 510-8008, Japan.

Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.

出版信息

Osteoporos Int. 2018 Mar;29(3):769-772. doi: 10.1007/s00198-017-4334-3. Epub 2017 Dec 11.

Abstract

We reported a 69-year-old female who discontinued denosumab due to dental treatment and subsequently suffered rebound-associated vertebral fractures 10 months after the last injection. This case raised an alarm regarding the discontinuation of denosumab for dental treatment. Denosumab, a human monoclonal antibody administered by subcutaneous injection, to the best of our knowledge, is the only fully investigated inhibitor of receptor activator of nuclear factor kappa B ligand. Discontinuation of denosumab leads to bone turnover rebound and rapid bone mineral density loss. Several studies have reported rebound-associated vertebral fractures after discontinuation of denosumab. We report on a new case of rebound-associated vertebral fractures after discontinuation of denosumab. A 69-year-old female, who withdrew from denosumab treatment after 3 years due to maxillitis, presented to our hospital with severe low back pain without any history of trauma. Ten months had passed since the last injection. Magnetic resonance imaging showed five acute vertebral fractures, which appeared to be rebound-associated vertebral fractures caused by discontinuation of denosumab due to dental treatment. This case clearly demonstrates the risk of discontinuation of denosumab for dental treatment.

摘要

我们报告了一例 69 岁女性患者,因牙科治疗而停用地舒单抗,最后一次注射后 10 个月发生了与反弹相关的椎体骨折。该病例引发了对因牙科治疗而停用地舒单抗的担忧。地舒单抗是一种通过皮下注射给药的人源化单克隆抗体,据我们所知,它是唯一经过充分研究的核因子κB 配体受体激活剂抑制剂。停用地舒单抗会导致骨转换反弹和骨密度迅速丢失。一些研究报告称,停用地舒单抗后会发生与反弹相关的椎体骨折。我们报告了一例新的停用地舒单抗后发生的与反弹相关的椎体骨折病例。一位 69 岁女性因上颌炎停用地舒单抗治疗 3 年后,因严重腰痛就诊,无外伤史。最后一次注射后已经过去了 10 个月。磁共振成像显示有 5 处急性椎体骨折,这些骨折似乎是由于牙科治疗停用地舒单抗导致的与反弹相关的椎体骨折。该病例清楚地表明了因牙科治疗而停用地舒单抗的风险。

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