Is there a potential dual effect of denosumab for treatment of osteoporosis and sarcopenia?

Journal article


Miedany, Yasser El, Gaafary, Maha El, Toth, Mathias, Hegazi, Mohamed Osama, Aroussy, Nadia El, Hassan, Waleed, Almedany, Samah, Nasr, Annie, Bahlas, Sami, Galal, S. and Egyptian Academy of Bone Health, Metabolic Bone Diseases 2021. Is there a potential dual effect of denosumab for treatment of osteoporosis and sarcopenia? Clinical Rheumatology. https://doi.org/10.1007/s10067-021-05757-w
AuthorsMiedany, Yasser El, Gaafary, Maha El, Toth, Mathias, Hegazi, Mohamed Osama, Aroussy, Nadia El, Hassan, Waleed, Almedany, Samah, Nasr, Annie, Bahlas, Sami, Galal, S. and Egyptian Academy of Bone Health, Metabolic Bone Diseases
AbstractThe prevalence of sarcopenia with osteoporosis results in a higher risk of falling and fractures. It was noted that patients who had completed their planned 5-year denosumab therapy course as treatment for these conditions started to sustain falls. To assess (a) whether denosumab has a unique dual effect on both bone and muscle in comparison to other anti-resorptive agents and (b) its effectiveness in the follow-up period post-treatment completion compared to other anti-resorptive agents. One hundred thirty-five patients diagnosed to have postmenopausal/senile osteoporosis and who were prescribed denosumab were compared to a control group of 272 patients stratified into 2 subgroups - 136 prescribed alendronate and 136 prescribed zoledronate. All patients were assessed for: BMD (DXA), falls risk (FRAS), fracture risk (FRAX), and sarcopenia measures. All were re-assessed after 5 years of denosumab/alendronate therapy and 3 years of zoledronate and 1 year after stopping the osteoporosis therapy. No significant baseline demographic differences between the 3 groups. On completion of the 5-year denosumab therapy, there was significant decrease in falls risk (P = 0.001) and significant improvements in all sarcopenia measures (P = 0.01). One-year post-discontinuation of denosumab, a significant worsening of both falls risk and sarcopenia measures (P = 0.01) noticed. Denosumab displayed positive impact and significant improvements in BMD and sarcopenia measures. It also enhanced multidirectional agility as depicted by Timed Up and Go (TUG). Collectively, this would explain the reduction of falls risk which got worse on stopping the medication. Key points • The coexistence of osteoporosis and sarcopenia has been recently considered in some groups as a syndrome termed 'osteosarcopenia'. • Bone and muscle closely interact with each other not only anatomically, but also at the chemical and metabolic levels. • Denosumab displayed positive impact and significant improvements in all sarcopenia measures, and enhanced multidirectional agility with consequent reduction in falls risk. • Denosumab can be considered as a first osteoporosis therapeutic option in this group of patients presenting with osteosarcopenia manifestations.
KeywordsAlendronate; Denosumab; Osteoporosis; Sarcopenia; Treatment; Zoledronate
Year2021
JournalClinical Rheumatology
PublisherSpringer
ISSN1434-9949
Digital Object Identifier (DOI)https://doi.org/10.1007/s10067-021-05757-w
Official URLhttps://link.springer.com/article/10.1007/s10067-021-05757-w
Publication dates
Online19 May 2021
Publication process dates
Accepted27 Apr 2021
Deposited03 Jun 2021
Accepted author manuscript
Output statusPublished
Permalink -

https://repository.canterbury.ac.uk/item/8xy40/is-there-a-potential-dual-effect-of-denosumab-for-treatment-of-osteoporosis-and-sarcopenia

Download files


Accepted author manuscript
  • 53
    total views
  • 15
    total downloads
  • 4
    views this month
  • 1
    downloads this month

Export as

Related outputs

Regenerative medicine : Challenges and opportunities
Plummer, S. and El Miedany, Y. 2022. Regenerative medicine : Challenges and opportunities. in: El Miedany, Y. (ed.) Musculoskeletal Ultrasound-Guided Regenerative Medicine Springer. pp. 539 -548
Rheumatology-led pregnancy clinic: patient-centred approach
El Miedany, Y. and Palmer, D. 2021. Rheumatology-led pregnancy clinic: patient-centred approach. Clinical Rheumatology. 40 (10), pp. 3875-3882. https://doi.org/10.1007/s10067-021-05690-y
Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis
Abu-Zaid, M., Salah S., Lotfy H., El Gaafary, M., Abdulhady, H., Tabra, S., Salah, H., Farag, Y., Eissa, M., Maher, S., Radwan, A., El-Shanawany, A., Medhat, B., El Mikkawy, D., Mosa D., El Deriny, G., Mortada M., Osman, N., Fouad, N., Elkaraly, N., Mohamed, S., Hassan, W., Amer, Y., Nasef, S. and El Miedany, Y. 2021. Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis. Therapeutic Advances in Musculoskeletal Disease. https://doi.org/10.1177/1759720X211059610
Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases
El Miedany, Y., Abu-Zaid, M., El Gaafary, M., El Naby, M., Fathi N., Saber H., Hassan, W., Eissa M., Mohannad N., Khaled H., Mortada M., Nasef S., Galal, S., Ghaleb R., Tabra S., Mohamed S., Medhat B., Aly H., Elolemy G., Fouad N., Ganeb S., Adel Y., Ibrahim M., Farouk O. and Gadallah N. 2021. Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases. Egyptian Rheumatology and Rehabilitation. 48 (5). https://doi.org/10.1186/s43166-020-00056-9
Consensus evidence-based clinical practice guidelines for the diagnosis and treat-to-target management of osteoporosis in Africa: an initiative by the African Society of Bone Health and Metabolic Bone Diseases.
El Miedany, Y., Paruk, F., Kalla, A., Adebajo, A., El Gaafary, M., El Maghraoui, A., Ngandeu, M., Dey, D., Gadallah, Naglaa, Elwy, Mohamed, Moosajee, F., Abu-Zaid, M., Galal, S., Miladi, S., Hassan, W., Fadlelmola, Abubaker and Saber, S. 2021. Consensus evidence-based clinical practice guidelines for the diagnosis and treat-to-target management of osteoporosis in Africa: an initiative by the African Society of Bone Health and Metabolic Bone Diseases. Archives of osteoporosis. 16 (1), p. 176. https://doi.org/10.1007/s11657-021-01035-z
Endorsement of the OMERACT core domain set for shared decision making interventions in rheumatology trials: Results from a multi-stepped consensus-building approach.
Toupin-April, K., Décary, S., de Wit, M., Meara, A., Barton, J. L., Fraenkel, L., Li, L. C., Brooks, P., Shea, B., Stacey, D., Légaré, F., Lydiatt, A., Hofstetter, C., Proulx, L., Christensen, R., Voshaar, M., Suarez-Almazor, M. E, Boonen, A., Meade, T., March, L., Jull, J. E., Campbell, W., Alten, R., Morgan, E.M., Kelly, A., Kaufman, J., Hill, S., Maxwell, L. J., Guillemin, F., Beaton, D., El-Miedany, Y., Mittoo, S., Westrich Robertson, T., Bartlett, S. J., Singh, J. A., Mannion, M., Nasef, S. I., de Souza, S., Boel, A., Adebajo, A., Arnaud, L., Gill, T. K., Moholt, E., Burt, J., Jayatilleke, A., Hmamouchi, I., Carrott, D., Blanco, F. J., Mather, K., Maharaj, A., Sharma, S., Caso, F., Fong, C., Fernandez, A. P., Mackie, S., Nikiphorou, E., Jones, A., Greer-Smith, R., Sloan, V. S., Akpabio, A., Strand, V., Umaefulam, V., Monti, S., Melburn, C., Abaza, N., Schultz, K., Stones, S., Kiwalkar, S., Srinivasalu, H., Constien, D., King, L. K. and Tugwell, P. 2021. Endorsement of the OMERACT core domain set for shared decision making interventions in rheumatology trials: Results from a multi-stepped consensus-building approach. Seminars in arthritis and rheumatism. 51 (3). https://doi.org/10.1016/j.semarthrit.2021.03.017
Rheumatology-led pregnancy clinic: enhancing the care of women with rheumatic diseases during pregnancy
El Miedany, Y. and Palmer, D. 2020. Rheumatology-led pregnancy clinic: enhancing the care of women with rheumatic diseases during pregnancy. Clinical Rheumatology. 39 (12), pp. 3593-3601. https://doi.org/10.1007/s10067-020-05173-6
Widespread lytic lesions—A metastatic or vasculitic process?
Fahd Khan, Srinivasan Srirangan, Yasser El Miedany and Sanjeev Madaan 2016. Widespread lytic lesions—A metastatic or vasculitic process? International Journal of Surgery Case Reports. 18, pp. 18-20. https://doi.org/10.1016/j.ijscr.2015.11.023