Gonzalez Rodriguez Elena, Lamy Olivier, Aubry-Rozier Bérengère, Stoll Delphine, Uebelhart Brigitte
Centre des maladies osseuses, Département de l'appareil locomoteur, CHUV, 1011 Lausanne.
Service d'endocrinologie, diabétologie et métabolisme, Département de médecine, CHUV, 1011 Lausanne.
Rev Med Suisse. 2019 Apr 17;15(647):831-835.
Denosumab discontinuation is associated with a severe rebound effect combining elevation of bone remodeling markers for two years and loss of the gained bone density. In the absence of a potent bisphosphonate prescription at denosumab discontinuation, multiple vertebral fractures are frequent. The median number of vertebral fractures is 5, within 7 to 20 months (median 11) after the last denosumab injection. A potent bisphosphonate prescribed at denosumab discontinuation may reduce this risk. This strategy requires close monitoring of bone remodeling markers and adjustment of treatment if bone remodeling is not controlled.
停用地诺单抗会引发严重的反弹效应，表现为骨重塑标志物升高持续两年以及已获得的骨密度丧失。在停用 地诺单抗时若未开具有效的双膦酸盐处方，多发性椎体骨折很常见。椎体骨折的中位数为 5 次，发生在最后一次注射地诺单抗后的 7 至 20 个月内（中位数为 11 个月）。在停用 地诺单抗时开具有效的双膦酸盐处方可能会降低这种风险。该策略需要密切监测骨重塑标志物，并在骨重塑未得到控制时调整治疗方案。
