Delayed Denosumab Injections and Bone Mineral Density Response: An Electronic Health Record-based Study.

Lyu, Houchen, Zhao, Sizheng S ORCID: 0000-0002-3558-7353, Yoshida, Kazuki, Tedeschi, Sara K, Xu, Chang, Nigwekar, Sagar U, Leder, Benjamin Z and Solomon, Daniel H (2020) Delayed Denosumab Injections and Bone Mineral Density Response: An Electronic Health Record-based Study. The Journal of clinical endocrinology and metabolism, 105 (5). dgz321-.

Text
Lyu - JCEM.pdf - Author Accepted Manuscript
Download (968kB) | Preview

Official URL: https://academic.oup.com/jcem/article-abstract/105...

Abstract

CONTEXT: Discontinuation of denosumab leads to a rapid reversal of its therapeutic effect. However, there are no data regarding how unintended delays or missed injections of denosumab impact bone mineral density (BMD) response. OBJECTIVE: We examined the association of delays in injections of denosumab with BMD change. DESIGN:We used electronic medical records from two academic hospitals from 2010 to 2017. PARTICIPANTS: Patients over 45 years of age and used at least two doses of 60mg denosumab. Denosumab adherence was evaluated by the medication coverage ratio (MCR). Good adherence corresponds to a dosing interval ≤7 months (defined by MCR ≥93%), moderate adherence corresponds to an interval of 7-10 months (MCR 75-93%), and poor adherence corresponds to an interval ≥10 months (MCR ≤74%). OUTCOME MEASURES: Annualized percent BMD change from baseline at the lumbar spine, total hip, and femoral neck. RESULTS:We identified 938 denosumab injections among 151 patients; the mean (SD) age was 69 (10) years, and 95% were female. Patients with good adherence had an annualized BMD increase of 3.9% at the lumbar spine, compared with patients with moderate (3.0%) or poor adherence (1.4%, p for trend 0.002). Patients with good adherence had an annualized BMD increase of 2.1% at the total hip, compared with patients with moderate (1.3%) or poor adherence (0.6%, p for trend 0.002). CONCLUSIONS: A longer interval between denosumab injections is associated with suboptimal BMD response at both spine and total hip. Strategies to improve the timely administration of denosumab in real-world settings are needed.

Item Type:	Article
Uncontrolled Keywords:	Osteoporosis, Denosumab, Dosing delay, Bone mineral density
Depositing User:	Symplectic Admin
Date Deposited:	07 Jan 2020 11:19
Last Modified:	19 Jan 2023 00:11
DOI:	10.1210/clinem/dgz321
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3069380