For high risk patients with systemic lupus erythematosus, teriparatide and denosumab may be an option for patients who have failed bisphosphonates. Here are some key points you need to know.
UCLA physicians writing in the journalÂ Current Treatment Options in Rheumatology, recommend bisphosphonates as first-line therapy for SLE patients.(1)Â Â Estrogen-containing drugs are not recommended for first-line prevention and treatment of osteoporosis because of the elevated risk of cardiovascular disease. But for some high-risk patients who have failed bisphosphonates, teriparatide and denosumab are an option.In this slideshow, we highlight some key points about teriparatide and denosumab.
(1) Lin T, Grossman J. Prevention and Treatment of Bone Disease in Systemic Lupus Erythematosus. Current Treatment Options in Rheumatology Curr Treat Options in Rheum. 2016;2(1):21-35. doi:10.1007/s40674-016-0034-y.
(2) Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res. 2010;62(11):1515–26.
(3) Saag KG, Shane E, Boonen S, Marin F, Donley DW, Taylor KA, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007;357(20):2028–39.
(4) Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361(8):756–65
(5) Lin T, Wang C, Cai XZ, Zhao X, Shi MM, Ying ZM, et al. Comparison of clinical efficacy and safety between denosumab and alendronate in postmenopausal women with osteoporosis: a meta-analysis. Int J Clin Pract. 2012;66(4):399–408
(6) Komm BS, Morgenstern D, AY L, Jenkins SN. The safety and tolerability profile of therapies for the prevention and treatment of osteoporosis in postmenopausal women. Expert Rev Clin Pharmacol. 2015;20:1–16. An excellent review on side effects of osteoporosis therapies.