Denosumab in the treatment of glucocorticoid-induced osteoporosis

Rheumatol Int. 2018 Nov;38(11):1975-1984. doi: 10.1007/s00296-018-4106-1. Epub 2018 Jul 17.

Abstract

Glucocorticoid therapy is the number one cause of secondary osteoporosis particularly effecting young individuals. Possessing an increased risk for fractures, glucocorticoid-induced osteoporosis might interfere with patients' well-being and quality of life. Therefore, proper treatment of bone loss and prevention from fractures are of great importance. There are a limited number of therapeutic and preventative options for glucocorticoid-induced osteoporosis. Denosumab, with its high anti-resorptive potential, has been studied several times among patients on glucocorticoid therapy. However, a comprehensive look analysing the current data is lacking. Thus, the objective of the current article is to evaluate the current evidence on the efficacy, as well as the safety profile of denosumab in glucocorticoid-induced osteoporosis. Pubmed/MEDLINE, Scopus and Web of Science databases were searched for the terms denosumab, glucocorticoid-induced osteoporosis, steroid-induced osteoporosis, glucocorticoids and osteoporosis. Relevant data regarding the efficacy and safety of denosumab among patients with glucocorticoid-induced osteoporosis was analysed. Denosumab contributes to increased bone mineral density and decreased bone-turnover marker levels among glucocorticoid users. It is an effective therapeutic option with a favourable safety profile in glucocorticoid-induced osteoporosis.

Keywords: Denosumab; Glucocorticoid-induced osteoporosis; Glucocorticoids; Osteoporosis.

Publication types

  • Review

MeSH terms

  • Bone Density / drug effects*
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Remodeling / drug effects*
  • Bone and Bones / drug effects*
  • Bone and Bones / pathology
  • Bone and Bones / physiopathology
  • Denosumab / adverse effects
  • Denosumab / therapeutic use*
  • Glucocorticoids / adverse effects*
  • Humans
  • Osteoporosis / chemically induced
  • Osteoporosis / diagnosis
  • Osteoporosis / drug therapy*
  • Osteoporosis / physiopathology
  • Risk Factors
  • Treatment Outcome

Substances

  • Bone Density Conservation Agents
  • Glucocorticoids
  • Denosumab