Introduction:

Osteoporosis development is a frequent complication associated with spinal cord injury (SCI), especially at the sublesional level. However, at present, data on its treatment are scarce.

Aim:

To analyze bone mineral density (BMD) and bone turnover markers (BTM) after 2-year treatment with denosumab in individuals with SCI-related osteoporosis.

Methods:

Prospective study including patients with recent SCI and related osteoporosis treated with denosumab for 24 months. In all patients, BTMs (bone ALP, sCTX and PINP), 25-OH-vitamin D levels and lumbar and femoral BMD were assessed at baseline and at 12 and 24 months.

Results:

13 patients (aged 39±15 years) with recent SCI (mean duration of 15 months) and osteoporosis treated with denosumab for 24 months were included. Patients showed a significant increase in BMD at lumbar spine and proximal femur after 12 months of treatment with denosumab, with a further increase in BMD at 24 months of follow-up, reaching an increase of 9.1% in lumbar spine, 4.4% in femoral neck and 5.3% total femur, respectively. BTM significantly decrease at 12 months and remained decreased at 24 months of follow-up. No skeletal fractures or treatment-related adverse events were observed during follow-up.

Conclusions:

Treatment with denosumab during 24 months increases lumbar and femoral BMD and decreases BTMs in patients with recent SCI. Denosumab may be a promising therapeutic option in SCI-related osteoporosis.

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