![]() ![]() Consequently, denosumab abrogates bone resorption, increases bone mineral density (BMD), and prevents fragility fractures. Denosumab is a fully human monoclonal antibody against RANKL that has been shown to selectively inhibit osteoclastogenesis. Receptor activator of nuclear factor-kappa B ligand (RANKL) is a cytokine that is essential for the differentiation, activation, and survival of osteoclasts. Therapies for osteoporosis are based on an understanding of bone biology. The purpose of osteoporosis treatment is the prevention of fractures to maintain the activities of daily living and to thereby reduce the risk of morbidity and mortality. Osteoporosis is a widespread skeletal disorder that necessitates long-term care and management. Compared with denosumab monotherapy, combination therapy of denosumab with vitamin D and calcium stopped the decrease in calcium caused by denosumab, inhibited bone metabolism to a greater extent, and increased BMD (especially at the hips). ![]() H-BMD was significantly increased in the combination group (3.6%) compared with the denosumab group (1.2%) at 12 months ( P<0.05). L-BMD significantly increased at 8 and 12 months (8.9%) in the combination group and at 4, 8 and 12 months (6.0%) in the denosumab monotherapy group, compared with those before treatment. BAP was significantly suppressed in both groups at 2–12 months. In the combination group, TRACP-5b was significantly decreased compared with the denosumab monotherapy group at 2 and 4 months ( P<0.05). TRACP-5b and urinary NTX were significantly suppressed in both groups from 1 week to 12 months (except at 12 months for NTX). There was no significant difference in patient background. We also measured bone mineral density (BMD) of L1–4 lumbar vertebrae (L)-BMD and bilateral hips (H)-BMD at baseline and at 4, 8 and 12 months. We measured serum bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRACP)-5b and urinary N-terminal telopeptide of type-I collagen (NTX) at baseline, 1 week, as well as at 1 month and 2, 4, 8 and 12 months. Patients were split into a denosumab monotherapy group (18 cases) or a denosumab plus vitamin D supplementation group (combination group 23 cases). To evaluate the differences in outcomes of treatment with denosumab alone or denosumab combined with vitamin D and calcium supplementation in patients with primary osteoporosis. ![]()
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