Denosumab
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Rebound-associated vertebral fractures following denosumab withdrawal: 2 case reports A report described a 66-year-old woman and 52-year-old woman, who developed rebound-associated vertebral fractures (RAVFs) following withdrawal of denosumab [routes, dosages and outcomes not stated; not all indication stated] . Case 1: The 66-year-old woman, who initially received alendronate for 1 year, received denosumab injection for 5 consecutive years. She received the last injection of denosumab in March 2019. Her last lumbar spine (LS) bone mineral density T-score (while on denosumab) was found to be –1.7. Subsequently, denosumab was stopped. After 7 months, she experienced a sharp back pain. Lateral spine X-rays showed RAVFs at L1 and L2 and a possible fracture at L4. An MRI showed additional recent fractures at T10, T11, L3, and verified the fracture at L4. Later, she was resumed denosumab therapy. Case 2: The 52-year-old woman, who had rheumatoid arthritis, treated with methylprednisolone daily and methotrexate. The basline LS BMD T-score was found to be –3.0. She started receiving denosumab in May 2014. She had her last injection of denosumab in May 2018. After 4.5 years, her BMD T-score of was –2.6 at the LS and –1.3 at her left femoral neck. She neglected her following injection. Nine months after her last injection she experienced a sudden sharp back pain while walking with her dog. Conventional X-rays did not reveal any fracture; however, an MRI showed grade 2 fracture at L1. Subsequently, she was resumed denosumab therapy. Two months later, a new X-ray showed the fracture. Anastasilakis AD, et al. Magnetic resonance imaging has an advantage over conventional spine X-rays in the evaluation of rebound-associated vertebral fractures following 803503922 denosumab discontinuation. Endocrine 69: 516-518, No. 3, Sep 2020. Available from: URL: http://doi.org/10.1007/s12020-020-02333-1
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Reactions 26 Sep 2020 No. 1823
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