Study Suggests Denosumab May Treat TDT-Induced Osteoporosis

Former medical instructor Dr. Kenneth D. Nahum is a hematologist and oncologist with Regional Cancer Care Associates in New Jersey. Active in the professional community, Dr. Kenneth D. Nahum has won numerous awards for his work and maintains membership in such organizations as the American Society of Hematology.

As part of its efforts to prevent and further the treatment of various blood disorders, the American Society of Hematology promotes education, training, and research into conditions that affect the blood, bone marrow, and immune and other systems. Recently, the organization announced the results of a study on osteoporosis and transfusion-dependent thalassemia, or TDT, an inherited blood disorder that causes the body to produce fewer red blood cells and less hemoglobin than usual. 

Forty percent of people with TDT develop osteoporosis, a bone disease characterized by weak and porous bones that cause pain and fracture more easily than healthy bones. To treat these comorbidities, most physicians use intravenous bisphosphonate agents, like zoledronic acid.

However, people with osteoporosis and thalassemia often have high levels of RANKL, an osteoporosis regulator. To reduce these high levels, researchers in the study, published in the journal of the American Society of Hematology, tried using twice-yearly injections of intravenous denosumab. Patients who received denosumab experienced a 5.92 percent increase in lumbar bone density, compared to a 2.92 percent increase among patients who received placebo injections. Further, denosumab resulted in less bone mineral density loss in the wrist, increased femoral neck density, and reduced pain.

Although denosumab is approved by the FDA for reducing RANKL amounts, it is not an approved therapy for people with TDT-induced osteoporosis. Researchers also acknowledge that more studies are necessary to compare denosumab to bisphosphonates to determine whether denosumab is a viable new treatment option.