Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;29(4):217-223.
doi: 10.11005/jbm.2022.29.4.217. Epub 2022 Nov 30.

The Role of Bisphosphonates Prior to Denosumab Treatment on Rebound Fractures: A Mini Review

Arthur Costa Inojosa  1 , Laís Mendes  1 , Leonardo Bandeira  2 , Francisco Bandeira  3
Affiliations

The Role of Bisphosphonates Prior to Denosumab Treatment on Rebound Fractures: A Mini Review

Arthur Costa Inojosa et al. J Bone Metab. 2022 Nov.

Abstract

Denosumab is a potent anti-resorptive medication used to treat patients at high risk for osteoporosis; however, its beneficial effects on the skeletal system are quickly reversed after discontinuation. In contrast, bisphosphonates (BPs) are anti-resorptive agents with residual effects on the bone matrix; thus, these are capable of preserving bone mass for a long time. Therefore, subsequent anti-resorptive treatment with BPs is mandatory to prevent rebound fractures. Furthermore, BP administration before denosumab treatment appears to be a reasonable strategy for reducing hyperactivation of bone remodeling. In this review, we summarize the effects of BP administration before denosumab treatment in preventing rebound fractures after denosumab discontinuation.

Keywords: Bisphosphonates; Denosumab; Fractures, bone; Osteoporosis.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

References

    1. Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25:2359–81. doi: 10.1007/s00198-014-2794-2. - DOI - PMC - PubMed
    1. Hernlund E, Svedbom A, Ivergård M, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA) Arch Osteoporos. 2013;8:136. doi: 10.1007/s11657-013-0136-1. - DOI - PMC - PubMed
    1. Bone HG, Bolognese MA, Yuen CK, et al. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2011;96:972–80. doi: 10.1210/jc.2010-1502. - DOI - PubMed
    1. Bone HG, Wagman RB, Brandi ML, et al. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet Diabetes Endocrinol. 2017;5:513–23. doi: 10.1016/s2213-8587(17)30138-9. - DOI - PubMed
    1. Anastasilakis AD, Makras P, Yavropoulou MP, et al. Denosumab discontinuation and the rebound phenomenon: A narrative review. J Clin Med. 2021;10:152. doi: 10.3390/jcm10010152. - DOI - PMC - PubMed