Romosozumab Treatment After Parathyroidectomy for Primary Hyperparathyroidism-Complicated Osteoporosis: A Two-Case Report
Abstract
Background/objective: Parathyroidectomy increases bone mineral density (BMD) by 3% to 4% in patients with primary hyperparathyroidism (PHPT); however, limited studies have demonstrated the effect of postoperative medical therapy, particularly with bisphosphonate and denosumab, on BMD. Herein, we report 2 cases of PHPT in which romosozumab, an antisclerostin antibody, increased BMD after parathyroidectomy.
Case report: Case 1. A 67-year-old woman was diagnosed with PHPT and advanced osteoporosis, with T-scores of -4.0 and -5.4 in the lumbar spine (LS) and distal radius (DR), respectively. After parathyroidectomy and 5-year treatment with eldecalcitol and raloxifene, T-scores were -3.3 and -5.6 in the LS and DR, respectively. Thereafter, 12-month romosozumab therapy with eldecalcitol increased BMD by 25.2% (0.717 to 0.898 g/cm2) and 4.0% (0.351 to 0.365 g/cm2) in the LS and DR, respectively. Case 2. A 64-year-old woman was diagnosed with PHPT and advanced osteoporosis, with T-scores of -4.1 and -4.9 in the LS and DR, respectively. Four months after parathyroidectomy, 12-month therapy with romosozumab and eldecalcitol increased BMD by 30.1% (0.602 to 0.783 g/cm2) and 4.3% (0.532 to 0.555 g/cm2) in the LS and total hip, respectively.
Discussion: We present the first reported cases of PHPT-complicated osteoporosis in which BMD improved after romosozumab treatment markedly in the LS by 25% to 30%. These cases suggest that postoperative romosozumab therapy may be a potential…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.