Case Report: Reopening the anabolic window — romosozumab added to ongoing denosumab for severe osteoporosis in two kidney transplant recipients - Summary - MDSpire
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Case Study: Reactivating the Anabolic Window — The Use of Romosozumab Alongside Denosumab in Two Female Patients with Severe Osteoporosis Post-Kidney Transplant
To evaluate the effects of combining romosozumab with denosumab in two female kidney transplant recipients with severe osteoporosis and high fracture risk.
Approach:
Patient Profiles: Two women with kidney transplants and severe osteoporosis received romosozumab (210 mg monthly) alongside ongoing denosumab treatment for 12 months.
Monitoring: Bone formation markers (P1NP and BAP), bone mineral density (BMD), serum calcium, parathyroid hormone, 25-hydroxyvitamin D, and allograft function were monitored throughout the treatment.
Key Findings:
Both patients showed early increases in bone formation markers (P1NP and BAP).
BMD increased at the lumbar spine by 5.9% in Case 1 and 11.2% in Case 2.
Modest changes were observed at the femoral neck and total hip.
Serum calcium, parathyroid hormone, and allograft function remained stable.
No clinically significant hypocalcemia or new vertebral fractures occurred.
Limitations:
Limited sample size with only two case reports.
Lack of long-term follow-up data beyond 12 months.
by Simona Barbuto, Paolo Mastromauro, Guido Zavatta, Daniele Vetrano, Anna Mistretta, Nicolò Bisceglia, Giorgia Comai, Uberto Pagotto, Gaetano La Manna, Giuseppe Cianciolo
As osteoporosis treatment continues to evolve, clinicians are moving beyond bone mineral density scores alone and placing greater emphasis on fracture risk when making therapeutic decisions
