Anastasilakis Athanasios D, Evangelatos Gerasimos, Makras Polyzois, Iliopoulos Alexios
Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece.
Department of Rheumatology, 417 "NIMTS", Army Shared Fund Hospital, Athens, Greece.
Bone Rep. 2020 Apr 22;12:100267. doi: 10.1016/j.bonr.2020.100267. eCollection 2020 Jun.
Denosumab discontinuation has been associated with increased risk of rebound-associated multiple vertebral fractures. We report the cases of three patients, two females and one male, who had manifested rebound-associated vertebral fractures after denosumab discontinuation and sustained new vertebral fractures a few months later. Two of the patients had been previously treated with bisphosphonates. Patients discontinued denosumab after 2 to 8 years of treatment. One of the female patients was receiving prednisolone 7.5 mg daily for an unspecified connective tissue disorder and the male patient methylprednisolone 8 mg daily for dermatomyositis. We hypothesize that rebound-associated multiple vertebral fractures after denosumab discontinuation may occur, at least in some cases, sequentially instead of simultaneously. Our cases further underpin the need for prompt initiation of potent antiresorptives in patients who sustained rebound-associated vertebral fractures, in order to prevent not only bone loss but also a second round of fractures.
停用地诺单抗与反跳相关的多发性椎体骨折风险增加有关。我们报告了三例患者的病例，其中两名女性和一名男性，他们在停用 地诺单抗后出现了反跳相关的椎体骨折，并在几个月后持续发生了新的椎体骨折。其中两名患者此前曾接受过双膦酸盐治疗。患者在接受 2 至 8 年的治疗后停用了地诺单抗。其中一名女性患者因未明确的结缔组织疾病每天服用 7.5 毫克泼尼松龙，男性患者因皮肌炎每天服用 8 毫克甲泼尼龙。我们推测，至少在某些情况下，停用 地诺单抗后反跳相关的多发性椎体骨折可能是相继发生而非同时发生。我们的病例进一步强调了对于发生反跳相关椎体骨折的患者需要迅速开始使用有效的抗吸收药物，以不仅防止骨质流失，还防止第二轮骨折。
