Please use this identifier to cite or link to this item:
Title: Efficacy of Zoledronic Acid in Maintaining Areal and Volumetric Bone Density after Combined Denosumab and Teriparatide Administration: DATA-HD Study Extension.
Austin Authors: Ramchand, Sabashini K ;David, Natalie L;Lee, Hang;Eastell, Richard;Tsai, Joy N;Leder, Benjamin Z
Affiliation: Medicine (University of Melbourne)
Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Harvard University, Boston, MA, USA
Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
Academic Unit of Bone Metabolism, University of Sheffield, United Kingdom
Issue Date: May-2021
Date: 2021-01-28
Publication information: Journal of Bone and Mineral Research 2021; 36(5): 921-930
Abstract: Combined teriparatide and denosumab rapidly and substantially increases bone mineral density (BMD) at all anatomic sites. Discontinuation of denosumab however, results in high-turnover bone loss and increased fracture risk. The optimal way to prevent this bone loss remains undefined. This study is a pre-planned extension of the DATA-HD study, where postmenopausal women with osteoporosis were randomized to receive 9 months of either 20-μg or 40-μg of teriparatide daily overlapping with denosumab (60-mg administered at months 3 and 9). At the completion of this 15-month study, women were invited to enroll in the DATA-HD Extension where they received a single dose of zoledronic acid (5-mg) 24-35 weeks after the last denosumab dose. Areal BMD and bone turnover markers were measured at month 27 and 42 (12 and 27 months after zoledronic acid, respectively) and spine and hip volumetric bone density by quantitative CT was measured at month 42. Fifty-three women enrolled in the DATA-HD Extension. At the femoral neck and total hip, the mean 5.6% and 5.1% gains in BMD achieved from month 0-15 were maintained both 12 and 27 months after zoledronic acid administration. At the spine, the mean 13.6% gain in BMD achieved from month 0-15 was maintained for the first 12 months but modestly decreased thereafter resulting in a 3.0% reduction (95% CI -4.0 to -2.0%, P<0.0001) 27 months after zoledronic acid. The pattern of BMD changes between months 15-42 were qualitatively similar in the 20-μg and 40-μg groups. A single dose of zoledronic acid effectively maintains the large and rapid total hip and femoral neck BMD increases achieved with combination teriparatide/denosumab therapy for at least 27 months following the transition. Spine BMD was also largely, though not fully, maintained during this period. These data suggest that the DATA-HD Extension regimen may be an effective strategy in the long-term management of patients at high risk of fragility fracture.
DOI: 10.1002/jbmr.4259
ORCID: 0000-0002-6755-8469
Journal: Journal of Bone and Mineral Research
PubMed URL: 33507574
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Page view(s)

checked on Dec 7, 2023

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.