Letter to the Editor: Severe Rebound-Associated Vertebral Fractures After Denosumab Discontinuation: Nine Clinical Cases Report

摘要

On 12 October 2016, The Journal of Clinical Endocrinology and Metabolism published online a clinical case report by Lamy et al. (1) concerning 9 women who presented 50 rebound-associated vertebral fractures after denosumab discontinuation. I would like to congratulate the authors on raising several interesting issues related to denosumab discontinuation in osteoporotic patients. In so doing, however, I disagree with their statement that before treatment, fracture risk was low for most of these women. As is depicted in their Table 2, all women except 1 have had very low lumbar spine bone mineral density (BMD; T score = –2.8 to –4.5), and many epidemiological studies have reported that low BMD in the spine is an important risk factor for incident vertebral fractures (2, 3) not enclosed in the FRAX fracture risk assessment tool (4). I think,...