Denosumab Discontinuation Rate in Patients Who Presented with Osteoporotic Vertebral Fracture During Pandemic

Objective: Social distancing mitigates transmission of Coronavirus disease-2019 but also can delay access to parenteral osteoporosis therapy. After discontinuation of denosumab therapy without concomitant biphosphanate use results with increased rate of multiple vertebral fractures within 2 to 10 months.
Methods: In this study, we wanted to evaluate whether restrictions during the pandemic resulted in an increased fracture rate due to denosumab discontination. For this, we compared the data between 2020-2021, when the restrictions were the most intense, and 2022-2023, when the restrictions were relaxed. Prospectively collected data of patients who applied to the neurosurgery clinic with osteoporotic vertebral fractures between 2020-2021 and 2022-2023 were retrospectively analyzed.
Results: A total of 49 patients were met the inclusion criteria, denosumab discontinuation was detected in five patients who presented with osteoporotic fractures during the period of intense restrictions, there was no patients with denosumab discontinuation during the period when the restrictions were relaxed. Discontinuation reasons was due to fear of access to hospital and mobility restriction in all patients. Mean time interval between treatment discontinuation and fracture occurrence was 12.6 months (10-15 months).
Conclusion: Patients should be warned about the durability of denosumab treatment, and if there is doubt about the durability, oral bisphosphonate therapy should be temporarily switched in pandemic.