TY - JOUR
TI - Denosumab discontinuation and the rebound phenomenon: A narrative review
AU - Anastasilakis, A.D.
AU - Makras, P.
AU - Yavropoulou, M.P.
AU - Tabacco, G.
AU - Naciu, A.M.
AU - Palermo, A.
JO - Journal of Clinical Medicine Research
PY - 2021
VL - 10
TODO - 1
SP - 1-28
PB - MDPI
SN - 1918-3003, 1918-3011
TODO - 10.3390/jcm10010152
TODO - biological marker;  denosumab, bone;  bone density;  bone metabolism;  bone turnover;  disease predisposition;  drug mechanism;  drug withdrawal;  fracture;  human;  osteolysis;  osteoporosis;  patient care;  randomized controlled trial (topic);  rebound;  Review
TODO - Denosumab is a potent antiresorptive agent that substantially increases bone mineral density and reduces fracture rates at all skeletal sites for as long as it is administered. However, its favorable skeletal effects reverse quickly upon its discontinuation, because of a vast increase of osteoclast number and activity, which leads to a subsequent profound increase of bone turnover above pre-treatment values, a phenomenon commonly described as “rebound phenomenon”. More importantly, most patients experience rapid, profound bone loss due to this burst of bone resorption that may lead in a minority of these patients to occurrence of fractures, especially multiple vertebral fractures. Therefore, subsequent antiresorptive treatment is mandatory, although the optimal regimen is yet to be clarified. In the present review, we outline what is currently known regarding the negative effects of denosumab discontinuation on different aspects of bone status, the factors that may affect them, and strategies to prevent them. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
ER -