Denosumab in active Charcot neuro-osteoarthropathy of the foot
Copyright © 2021 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved..
OBJECTIVE: Active Charcot Neuro-osteoarthropathy (CN) is a rare and severe complication of peripheral neuropathy that leads to deformity and disability. No pharmacological treatment is available. Increased osteoclastic activity plays a central role in active CN, particularly via receptor activator of nuclear factor ligand (RANK-L). We aimed to describe clinical, morphological and metabolic imaging effects of denosumab, a fully human monoclonal anti- RANK-L antibody, in active CN.
METHODS: In this open-label study, we included all consecutive patients with active refractory CN treated with denosumab in our tertiary center. Baseline and follow-up assessment included clinical examination, biological and imaging procedures (morphological and metabolic) before and after treatment.
RESULTS: Seven patients were treated with denosumab between 2017 and 2020 and followed for a median of 16 months [6-39]. All patients clinically improved, 4 further relapsed after a median of 4 months [3-33]. Four patients were retreated with the same efficacy. Imaging follow-up available in 5 patients showed stability of structural damage (radiography) and a significant decrease of metabolic activity (FDG PET-CT) in 4 of them. No adverse event or hypocalcemia was observed.
CONCLUSION: In patients with refractory active CN, denosumab had a clinical effect, prevented bone and joint destruction, together with a metabolic effect, as assessed by FDG PET-CT. These results justify the conduction of a randomized controlled trial to assess the efficacy of denosumab in acute CN.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:88 |
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| Enthalten in: |
Joint bone spine - 88(2021), 6 vom: 01. Dez., Seite 105241 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Carvès, Sandrine [VerfasserIn] |
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| Links: |
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| Themen: |
4EQZ6YO2HI |
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| Anmerkungen: |
Date Completed 06.04.2022 Date Revised 06.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jbspin.2021.105241 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326941681 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved. | ||
| 520 | |a OBJECTIVE: Active Charcot Neuro-osteoarthropathy (CN) is a rare and severe complication of peripheral neuropathy that leads to deformity and disability. No pharmacological treatment is available. Increased osteoclastic activity plays a central role in active CN, particularly via receptor activator of nuclear factor ligand (RANK-L). We aimed to describe clinical, morphological and metabolic imaging effects of denosumab, a fully human monoclonal anti- RANK-L antibody, in active CN | ||
| 520 | |a METHODS: In this open-label study, we included all consecutive patients with active refractory CN treated with denosumab in our tertiary center. Baseline and follow-up assessment included clinical examination, biological and imaging procedures (morphological and metabolic) before and after treatment | ||
| 520 | |a RESULTS: Seven patients were treated with denosumab between 2017 and 2020 and followed for a median of 16 months [6-39]. All patients clinically improved, 4 further relapsed after a median of 4 months [3-33]. Four patients were retreated with the same efficacy. Imaging follow-up available in 5 patients showed stability of structural damage (radiography) and a significant decrease of metabolic activity (FDG PET-CT) in 4 of them. No adverse event or hypocalcemia was observed | ||
| 520 | |a CONCLUSION: In patients with refractory active CN, denosumab had a clinical effect, prevented bone and joint destruction, together with a metabolic effect, as assessed by FDG PET-CT. These results justify the conduction of a randomized controlled trial to assess the efficacy of denosumab in acute CN | ||
| 650 | 4 | |a Case Reports | |
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| 650 | 4 | |a Denosumab | |
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| 700 | 1 | |a Mariette, Xavier |e verfasserin |4 aut | |
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