Abstract | INTRODUCTION: METHODS: This retrospective, single-center study included 80 patients (10 males, 70 females) with fresh osteoporotic vertebral fractures treated using denosumab at a dose of 60 mg subcutaneously every 6 months (40 patients) or alendronate at a dose of 35 mg orally every week (40 patients) for 6 months in our hospital. The mean age of subjects was 77 years (range, 55-92 years). The primary outcome was duration of back pain. Secondary outcomes included changes in BMD, serum type 1 collagen cross-linked N-telopeptide (NTX), and serum N-terminal propeptide of type 1 collagen (P1NP) from baseline to 6 months. Pain catastrophizing due to back pain was assessed using the Pain Catastrophizing Scale (PCS). The incidences of further vertebral fracture and adverse events were also assessed. RESULTS:
Pain relief was obtained at a mean of 3.3 weeks with denosumab and 5.4 weeks with alendronate. Pain relief was achieved significantly earlier with denosumab than with alendronate. At 6 months, change in BMD was higher with denosumab (6.1%) than with alendronate (0.8%). No significant differences in changes in NTX and P1NP were observed between groups. Scores for PCS were significantly lower for denosumab than for alendronate. The incidence of further vertebral fractures was 5% with denosumab and 10% with alendronate. Adverse event rates were similar between groups. CONCLUSIONS:
Denosumab enabled earlier pain relief than alendronate and avoided catastrophizing in patients with osteoporotic vertebral fractures after 6 months of treatment.
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Authors | Tomoko Tetsunaga, Tomonori Tetsunaga, Keiichiro Nishida, Masato Tanaka, Yoshihisa Sugimoto, Tomoyuki Takigawa, Yoshitaka Takei, Toshifumi Ozaki |
Journal | Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
(J Orthop Sci)
Vol. 22
Issue 2
Pg. 230-236
(Mar 2017)
ISSN: 1436-2023 [Electronic] Japan |
PMID | 28087216
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved. |
Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Alendronate
(therapeutic use)
- Cohort Studies
- Denosumab
(therapeutic use)
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Female
- Follow-Up Studies
- Fracture Healing
(drug effects)
- Humans
- Low Back Pain
(diagnostic imaging, drug therapy, etiology)
- Male
- Middle Aged
- Osteoporotic Fractures
(complications, diagnostic imaging, drug therapy)
- Pain Measurement
- Retrospective Studies
- Risk Assessment
- Spinal Fractures
(diagnostic imaging, drug therapy)
- Tomography, X-Ray Computed
(methods)
- Treatment Outcome
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