Bone Abstracts

Background: Denosumab is licensed for the treatment of osteoporosis in the UK. Guidance issued by NICE and SMC in indicated that Denosumab may be used in the treatment of patients with postmenopausal osteoporosis who are unsuitable for other treatments. Here we have reviewed the clinical characteristics of patients treated within a secondary care referral centre adverse events encountered during treatment.

Methods: We reviewed data from 75 consecutive patients treated with Denosumab between 2010 and 2012.

Results: Most patients (88%) had postmenopausal osteoporosis and 80% had previously been on other osteoporosis treatments. Seven male osteoporotic patients (9%) were treated. All patients were given vitamin D supplements prior to commencing Denosumab and combined calcium and vitamin D supplements during treatment. The mean duration of Denosumab therapy was 21.7±5.4 months, with the most common indications being GI intolerance with oral bisphosphonates (n=24), poor renal function (n=17) and poor compliance with oral bisphosphonates (n=10). Overall compliance with NICE guidelines was 63% and SMC guidance was 65%. Treatment was generally well tolerated and mild hypocalcaemia was observed in only one patient, who in error had also been treated with alendronic acid.

Conclusion: Denosumab is a useful and safe treatment option for many patients in whom oral bisphosphonates are poorly tolerated or where compliance is an issue. Although most patients being treated with Denosumab fulfilled the guidance issued by NICE and SMC a substantial proportion did not.