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It is an effective treatment for osteoporosis with a reduced cumulative rate of vertebral fractures, hip and nonvertebral fractures as well as an increase in bone mineral density. The benefits have been shown to be maintained when treatment is continued up to and likely after 10 years of therapy, but the effects are lost rapidly if treatment is discontinued abruptly. There are rare medical indications for discontinuation of treatment. Discontinuation of denosumab is often driven by concern about complications such as osteonecrosis of the jaw, atypical femoral fractures and hypocalcaemia, which remain rare events. Further studies are required to confirm safety and efficacy beyond 10 years of treatment, but it is likely that patients will have ongoing benefits from therapy beyond this. We aim to present a personal perspective of why and how denosumab should be discontinued in patients with osteoporosis.<\/jats:p>","DOI":"10.1111\/cen.14747","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T01:48:47Z","timestamp":1650937727000},"page":"649-653","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["When and how to stop denosumab therapy in a patient with osteoporosis"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1048-3176","authenticated-orcid":false,"given":"Eirena L.","family":"Goulden","sequence":"first","affiliation":[{"name":"Department of Endocrinology St. Vincent's University Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1472-4117","authenticated-orcid":false,"given":"Rachel K.","family":"Crowley","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St. Vincent's University Hospital  Dublin Ireland"},{"name":"School of Medicine and Medical Science University College Dublin  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2008.04.007"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-1502"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.3337"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14550"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30138-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1606"},{"key":"e_1_2_9_8_1","first-page":"26","article-title":"Fracture risk and management of discontinuation of denosumab therapy: a systematic review and position statement by ECTS","volume":"10","author":"Tsourdi E","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.717168"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4098"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4305"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab321"},{"key":"e_1_2_9_13_1","unstructured":"Alendronate in an weekly effervescent tablet formulation for preservation of bone mass after denosumab discontinuation in postmenopausal women with low bone mass. 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