IBMS BoneKEy | BoneKEy Watch
Denosumab enhances bone strength, so reducing fracture risk
DOI:10.1038/bonekey.2014.61
Keaveny et al. performed a follow-up study on participants of the FREEDOM trial, which showed that postmenopausal women treated with denosumab every six months for three years had a reduced risk of hip and vertebral fractures of 40% and 68% respectively.
A subset of women had their quantitative hip and spine CT scans subjected to nonlinear finite element analysis (FEA) to estimate bone strength at those sites at the end of each study year. In the denosumab group, hip strength increased by 5.3% in the first 12 months and by 8.6% at the end of 36 months (P<0.0001 in both cases). No changes were seen in hip strength in the placebo group at 12 months but a decrease of 5.6% was noted by 36 months.
Spine strength also increased by 18.2% at the end of 36 months in women treated with denosumab. Spine strength in the placebo group fell by 4.2%. Further analysis revealed positive changes in the cortical and trabecular bone of women in the denosumab treated group.
Editor’s comment: Overall, the results demonstrated a significant increase in bone strength of 14.2% in the hip and 22.4% in the spine for treatment with denosumab with respect to controls after 36 months. The finite element analysis provides a plausible mechanism to explain the observed reduction in fracture risk in postmenopausal women treated with denosumab.
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