Denosumab improves trabecular bone score in relationship with decrease in fracture risk of women exposed to aromatase inhibitors

Journal of Endocrinological Investigation - Trang 1-10 - 2023
S. Antonini1,2, R. Pedersini3, M. F. Birtolo1,2, N. L. Baruch1, F. Carrone2, S. Jaafar1,2, A. Ciafardini1,2, D. Cosentini3, M. Laganà3, R. Torrisi4, D. Farina5, L. Leonardi6, L. Balzarini6, W. Vena7, A. C. Bossi7, A. Zambelli1,4, A. G. Lania1,2, A. Berruti3, G. Mazziotti1,2
1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
2Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
3Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
4Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Italy
5Radiology Unit 2, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Brescia, Italy
6Department of Radiology, IRCCS Humanitas Research Hospital, Rozzano, Italy
7Endocrinology, Humanitas Gavazzeni-Castelli, Bergamo, Italy

Tóm tắt

Trabecular bone score (TBS) is a gray-level textural metric that has shown to correlate with risk of fractures in several forms of osteoporosis. The value of TBS in predicting fractures and the effects of bone-active drugs on TBS in aromatase inhibitors (AIs)-induced osteoporosis are still largely unknown. The primary objective of this retrospective study was to assess the effects of denosumab and bisphosphonates (BPs) on TBS and vertebral fractures (VFs) in women exposed to AIs. 241 consecutive women (median age 58 years) with early breast cancer undergoing treatment with AIs were evaluated for TBS, bone mineral density (BMD) and morphometric VFs at baseline and after 18–24 months of follow-up. During the study period, 139 women (57.7%) received denosumab 60 mg every 6 months, 53 (22.0%) BPs, whereas 49 women (20.3%) were not treated with bone-active drugs. Denosumab significantly increased TBS values (from 1.270 to 1.323; P < 0.001) accompanied by a significant decrease in risk of VFs (odds ratio 0.282; P = 0.021). During treatment with BPs, TBS did not significantly change (P = 0.849) and incidence of VFs was not significantly different from women untreated with bone-active drugs (P = 0.427). In the whole population, women with incident VFs showed higher decrease in TBS vs. non-fractured women (P = 0.003), without significant differences in changes of BMD at any skeletal site. TBS variation predicts fracture risk in AIs treated women. Denosumab is effective to induce early increase of TBS and reduction in risk of VFs.

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