Treatment of glucocorticoid-induced osteoporosis with concurrent denosumab and romosozumab: a case report

Osteoporos Int. 2024 Nov;35(11):2061-2068. doi: 10.1007/s00198-024-07243-w. Epub 2024 Sep 17.

Abstract

Osteoporosis is a metabolic bone disorder for which treatment options include antiresorptive therapies (e.g., bisphosphonates, denosumab); anabolics (e.g., teriparatide, abaloparatide); and dual mechanisms (e.g., romosozumab). Management of osteoporosis with concurrent antiresorptive and anabolic agents may be superior to monotherapy, as demonstrated in the DATA trial with the combination of denosumab and teriparatide. However, there is limited experience with the combination of denosumab and romosozumab, which may be an alternative antiresorptive/anabolic regimen for individuals who are not candidates for PTH receptor agonists. In this case, we present a young man with glucocorticoid-induced osteoporosis who could not tolerate a daily injectable anabolic and who experienced improvement in bone mineral density with concurrent denosumab and off-label romosozumab administration.

Keywords: Denosumab; Osteoporosis; Romosozumab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal* / administration & dosage
  • Antibodies, Monoclonal* / adverse effects
  • Antibodies, Monoclonal* / therapeutic use
  • Bone Density Conservation Agents* / administration & dosage
  • Bone Density Conservation Agents* / therapeutic use
  • Bone Density* / drug effects
  • Denosumab* / administration & dosage
  • Denosumab* / adverse effects
  • Denosumab* / therapeutic use
  • Drug Therapy, Combination*
  • Glucocorticoids* / administration & dosage
  • Glucocorticoids* / adverse effects
  • Glucocorticoids* / therapeutic use
  • Humans
  • Male
  • Osteoporosis* / chemically induced
  • Osteoporosis* / drug therapy

Substances

  • Denosumab
  • Bone Density Conservation Agents
  • romosozumab
  • Glucocorticoids
  • Antibodies, Monoclonal