Denosumab Discontinuation in Primary Osteoporosis: Rebound Bone Turnover, Vertebral Fracture Risk and Sequential Treatment Strategies
Abstract
and reduces fracture risk, but its effect is rapidly reversible after delayed dosing or discontinuation because the drug does not remain incorporated in bone. This may cause rebound bone turnover, rapid loss of bone mineral density gains and increased risk of vertebral fractures,
particularly multiple vertebral fractures. This concise review summarizes the mechanism of rebound after denosumab interruption, risk factors for post-discontinuation vertebral fractures, sequential antiresorptive strategies and practical monitoring. The central clinical message is
that denosumab should not be stopped or substantially delayed without a planned follow-on antiresorptive treatment. Bisphosphonates are the
main sequential option, but the optimal regimen should be individualized according to fracture risk, duration of denosumab exposure, adherence and bone turnover response.
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DOI: http://dx.doi.org/10.70711/pmr.v3i9.9896
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