Results
Table 1 shows the baseline characteristics of our study patients. A
total of 56 patients were included, of which 54 were women (96.4%). The
mean age was 68.1 ± 8.2 years. The most frequently observed concomitant
diseases were arterial hypertension (32.1%), dyslipidemia (32.1%) and
hypothyroidism (16.1%). Most of the patients had not previously
suffered vertebral fractures (73.2%) and their risk of fracture
calculated at 10 years using the FRAX risk assessment tool after having
suffered multiple vertebral fractures was 11% for major fractures (95%
CI 6.1% -16%) and 3.9% for hip fractures (1.2% -6.6%). Patients had
been taking DMAB for a median of 30.5 months (95% CI: 24-43.5 months)
and had injected a median of 6 doses (95% CI: 4-8 doses). 56 patients
accumulated 192 new vertebral fractures.
Table 3 shows the reasons why
DMAB was
discontinued. Medical prescription was the main cause of suspending
treatment, which occurred in 62.7% of cases.
Table 4 shows the biochemical values studied, including the biochemical
markers of bone remodeling, obtained before and after DMAB suspension
and the appearance of multiple vertebral fractures. Values of calcium,
phosphorus, total proteins, vitamin D (25 hydroxycholecalciferol) and
PTH do not change substantially, but the biochemical markers of bone
remodeling increase significantly, both beta-crosslaps, P1NP and
osteocalcin (p <0.006 in all cases). The greatest increase
occurs in the beta-crosslaps, from 0.071 to 0.520 ng/mL median, a
14-fold increase in baseline values. Osteocalcin values almost tripled
while those of P1NP quadrupled.
Finally, Table 5 shows the logistic regression analysis to study the
possible association between the various clinical, analytical and
densitometric parameters and the number of vertebral fractures. The
length of time of previous DMAB use is the only parameter that was
associated in a statistically significant way (p= 0.04).