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Table 1 Patient’s characteristics during follow up

From: Long-term follow up after denosumab treatment for osteoporosis – rebound associated with hypercalcemia, parathyroid hyperplasia, severe bone mineral density loss, and multiple fractures: a case report

 

Clinical presentation

Fractures

T-score lumbar/total hip BMD (SD)

Calcaemia (mmol/l)

Treatments

Follow up of the patient (January 2005)

Bicycle fall

L2

−3.2/−2.1

2.50

Initiation: denosumab (60 mg semi-annually), calcium (1 g daily), vitamin D (800 IU daily)

FREEDOM 3-year evaluation (January 2008)

No pain

T5, T8, and aggravation of L2

−2.2/−1.7

2.52

Pursuit: denosumab (60 mg semi-annually), calcium (1 g daily), vitamin D (800 IU daily)

FREEDOM extension (September 2013)

No pain

No new fracture

−1.6/−1.1

2.73

All treatments stopped

Hospitalization (June 2014)

Acute intense dorsal pain

T4, T9, T10, T11, L1, L3

−2.0/−1.3

2.83

None

New evaluation (September 2016)

Chronic dorsal and lumbar pain

No new fracture

−2.9/−2.3

2.47

Zoledronate (two infusions of 5 mg annually), vitamin D (100,000 IU quarterly)

New evaluation (August 2018)

Chronic lumbar pain

No new fracture

−2.9/−2.3

2.60

Treatments stopped

  1. BMD bone mineral density, L1 first lumbar vertebra, L2 second lumbar vertebra, L3 third lumbar vertebra, SD standard deviation, T4 fourth thoracic vertebra, T5 fifth thoracic vertebra, T8 eighth thoracic vertebra, T9 ninth thoracic vertebra, T10 tenth thoracic vertebra, T11 11th thoracic vertebra