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| Name | Class |
|---|---|
| 251 Hellenic Air Force & VA General Hospital | OTHER |
| Leiden University Medical Center | OTHER |
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In contrast with bisphosphonates,discontinuation of denosumab results in gradual loss of bone mineral density gains. The investigators aim to evaluate whether in patients treated with denosumab, a single zoledronic acid infusion would prevent the anticipated bone loss.
Discontinuation of denosumab results in a rebound rise of bone turnover markers and gradual loss of the achieved bone mineral density gains. In contrast, bisphosphonates, such as zoledronic acid, remain within the skeleton acting for several months or even years after discontinuation while maintaining bone mineral density despite the cessation of treatment. In this study, the investigators aim to evaluate changes in bone mineral density of the lumbar spine and the femoral neck, as well as in bone turnover markers one year after treatment discontinuation both in denosumab-treated women and in denosumab-treated women who switched to zoledronic acid infusion one year before treatment discontinuation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Denosumab | Active Comparator | Patients with low bone mass, being treated only with denosumab in the past, who will receive another year of treatment with denosumab and subsequently discontinue treatment for one year |
|
| Denosumab plus zoledronic acid | Experimental | Patients with low bone mass, being treated only with denosumab in the past, who will receive a single infusion of zoledronic acid and subsequently discontinue treatment for another year |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Denosumab | Drug | Treatment of low bone mass with subcutaneous injections of denosumab 60 mg every 6 months for one year |
|
| Measure | Description | Time Frame |
|---|---|---|
| bone mineral density of the lumbar spine | differences between the 2 arms in the changes of lumbar spine bone mineral density measured by dual-energy X-ray absorptiometry | from 12 to 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| bone mineral density of the femoral neck | differences between the 2 arms in the changes of femoral neck bone mineral density measured by dual-energy X-ray absorptiometry | from 12 to 24 months |
| C-terminal telopeptide of type I collagen |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Athanasios D Anastasilakis, PhD | 424 General Military Hospital, Thessaloniki, Greece | Principal Investigator |
| Polyzois Makras, PhD | 251 Airforce and VA General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 251 Airforce & VA General Hospital | Athens | 11525 | Greece | |||
| 424 General Military Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18539106 | Background | Miller PD, Bolognese MA, Lewiecki EM, McClung MR, Ding B, Austin M, Liu Y, San Martin J. Effect of denosumab on bone density and turnover in postmenopausal women with low bone mass after long-term continued, discontinued, and restarting of therapy: a randomized blinded phase 2 clinical trial. Bone. 2008 Aug;43(2):222-229. doi: 10.1016/j.bone.2008.04.007. Epub 2008 Apr 26. | |
| 21289258 |
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| ID | Term |
|---|---|
| D015663 | Osteoporosis, Postmenopausal |
| D010024 | Osteoporosis |
| ID | Term |
|---|---|
| D001851 | Bone Diseases, Metabolic |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D008659 | Metabolic Diseases |
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| ID | Term |
|---|---|
| D000069448 | Denosumab |
| D000077211 | Zoledronic Acid |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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| Zoledronic acid | Drug | Treatment of low bone mass with a single infusion of zoledronic acid 5 mg for one year |
|
|
differences between the 2 arms in the changes of C-terminal telopeptide of type I collagen
| from 12 to 15, 18, 24 months |
| propeptide of procollagen type I | differences between the 2 arms in the changes of propeptide of procollagen type I | from 12 to 15, 18, 24 months |
| bone mineral density of the lumbar spine | differences between the 2 arms in the changes of lumbar spine bone mineral density measured by dual-energy X-ray absorptiometry | from baseline to 12 months |
| bone mineral density of the femoral neck | differences between the 2 arms in the changes of femoral neck bone mineral density measured by dual-energy X-ray absorptiometry | from baseline to 12 months |
| Thessaloniki |
| 56429 |
| Greece |
| Background |
| Bone HG, Bolognese MA, Yuen CK, Kendler DL, Miller PD, Yang YC, Grazette L, San Martin J, Gallagher JC. 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 Apr;96(4):972-80. doi: 10.1210/jc.2010-1502. Epub 2011 Feb 2. |
| 22571169 | Background | Black DM, Bauer DC, Schwartz AV, Cummings SR, Rosen CJ. Continuing bisphosphonate treatment for osteoporosis--for whom and for how long? N Engl J Med. 2012 May 31;366(22):2051-3. doi: 10.1056/NEJMp1202623. Epub 2012 May 9. No abstract available. |
| 22571168 | Background | Whitaker M, Guo J, Kehoe T, Benson G. Bisphosphonates for osteoporosis--where do we go from here? N Engl J Med. 2012 May 31;366(22):2048-51. doi: 10.1056/NEJMp1202619. Epub 2012 May 9. No abstract available. |
| 33386953 | Derived | Anastasilakis AD, Polyzos SA, Yavropoulou MP, Appelman-Dijkstra NM, Ntenti C, Mandanas S, Papatheodorou A, Makras P. Comparative Effect of Zoledronate at 6 Versus 18 Months Following Denosumab Discontinuation. Calcif Tissue Int. 2021 May;108(5):587-594. doi: 10.1007/s00223-020-00785-1. Epub 2021 Jan 2. |
| D009750 |
| Nutritional and Metabolic Diseases |
| D007162 |
| Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D004164 | Diphosphonates |
| D063065 | Organophosphonates |
| D009943 | Organophosphorus Compounds |
| D009930 | Organic Chemicals |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |