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Cessation of denosumab therapy however is associated with rapid declines in bone mineral density (BMD), rises in bone remodeling, and an increased risk of fracture. We evaluated the effect of low dose denosumab (30\u2009mg every 6 months) on the prevention of bone loss following a switch from standard dose (60\u2009mg of denosumab every 6 months) in a prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 114 women 50\u201390 years of age with postmenopausal osteoporosis at a moderate fracture risk without prior fragility fractures, who had been on denosumab 60\u2009mg every 6 month. These women switched to low dose denosumab 30\u2009mg every 6 months. Mean percentage change in lumbar spine (LS), femoral neck (FN), total hip (TH) and 1\/3 distal radius (1\/3RAD) BMD at 12 and 24 months were evaluated. Predictors for change in BMD were explored. Subgroup analysis for patients on denosumab 60\u2009mg every 6 months for &lt;3 years and for \u22653 years before switching to low dose denosumab 30\u2009mg was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 12 months following a switch from 60\u2009mg to 30\u2009mg of denosumab every 6 months we observed an increase in LS BMD mean percentage change (+2.03%, 95% CI 1.18\u20132.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). BMD was stable at the hip and radial sites. Age was found to be a predictor of the mean percentage change in LS BMD for the overall sample. At 24 months, there was a further increase in LS BMD mean percentage change (+3.44%, 95% CI 1.74\u20135.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with stable BMD at other skeletal sites. The 12 month mean BMD percentage change at the LS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), FN (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), TH (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and 1\/3 RAD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were found to be predictors of the 24 month mean BMD percentage change. No clinical fractures were reported during 24 months of follow up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed stable BMD following a switch from denosumab 60\u2009mg every 6 months to 30\u2009mg every 6 months in this prospective observational study conducted in postmenopausal women at a moderate fracture risk<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-022-03230-5","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T16:27:25Z","timestamp":1682440045000},"page":"647-657","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Effect of low dose denosumab on bone mineral density in postmenopausal women with osteoporosis after a transition from 60\u2009mg dose: a prospective observational study"],"prefix":"10.1007","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3733-8956","authenticated-orcid":false,"given":"Aliya A.","family":"Khan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajar","family":"AbuAlrob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"M\u2019Hiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalal S.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel","family":"Dandurand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hosay","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Alkassem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Hakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismail","family":"Hweija","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman","family":"Iqbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Romanovschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehryar","family":"Mehmood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Zariffeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Guyatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quazi","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Brignardello-Petersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza I.","family":"Syed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"issue":"9","key":"3230_CR1","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/S1701-2163(15)30489-8","volume":"36","author":"A Khan","year":"2014","unstructured":"A. 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Khan recieved research grants for unrelated research projects from Alexion, Amgen, Ascendis, Chugai, Radius, Takeda, Ultragenyx. The authors Hajar AbuAlrob, Iman M\u2019Hiri, Dalal S. Ali, Karel Dandurand, Hosay Said, Hisham Alkassem<sup>,<\/sup> Yasser Hakami, Ismail Hweija, Salman Iqbal, Miki Romanovschi, Shehryar Mehmood, Hamza I. Syed, Heather Zariffeh, Gordon Guyatt, Quazi Ibrahim, Romina Brignardello-Petersen have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from all participants per GCP guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and publish"}},{"value":"The ethics review board approval was obtained from Veritas IRB Inc (Project ID: 16372-11:34:365-05-2020).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}