Postmenopausal osteoporosis is one of the most common diseases in women. The peculiarity of this disease is the reduction of bone mass. In the trabecular bone there is a violation of histoarchitecture, which is associated with the rupture of bone trabeculae, their relationship with each other, the presence of cracks and microflakes. Compact bone has resorptive cavities. Mechanisms of violations are associated with negative bone remodeling, incrising osteoclastic activity increases after menopause, resulting in a bone resorption process that exceeds bone formation. The basis of the negative remodeling of the bone is the activation of osteoclasts by RANKL receptors, which express osteoblasts. Denosumab is one of the target drugs, which are human monoclonal antibodies (IgG2) that specifically bind to RANKL and inhibit the differentiation of precursor cells in osteoclasts and their activity. The purpose of the study was to assess the bone mineral density (BMD) with postmenopausal osteoporosis women after treatment with denosumab. Object and methods. It was investigated the effectiveness of targeted therapy with denosumab on the Explorer QDR bone densitometer, Holodgic, 131 women with postmenopausal osteoporosis aged 58 to 66 years who were inpatient treatment or were treated outpatiently were screened. The experimental group of women received treatment with denosumab and calcium with vitamin D. The control group consisted of 30 women with osteoporosis treated with calcium alone with vitamin D. Bone mineral density (BMD) was evaluated of in the lumbar spine and proximal femur. Results. In the case of comparison of BMD before and after treatment with denosumab, a statistically significant increase in BMD in the lumbar spine was observed, which was recorded after 6 months, that is, after the first administration of the drug and for the following observation periods – 1; 1,5; 2 and 3 years. A year later, BMD in the lumbar spine was found to be 6.38 %, and the proximal femur was 2.83%. After 3 years, BMD in the lumbar spine in women was increased in 9.1%, and in the proximal femury in 4.18%, it was considered a positive result. Patients in the control group had a BMD at the level of 0.732 ± 0.03 g/cm2 for the first survey period (T-criterion was -2.8), after 3 years – 0.782 ± 0.04 g/cm2 (T-criterion was -2, 7). That is, the treatment of calcium with vitamin D3 only stabilize the BMD, but no increase in BMD was achieved. During the entire period of observation in patients, there was no deterioration in the clinical status and the occurrence of compression fractures of vertebrate and peripheral fractures. The growth rates in women for all terms of the survey remained stable, the average height was (157.5 ± 1.6) cm when included in the study and (157.4 ± 1.5) cm after 3 years. Conclusion. Thus, the study of the effect of the drug denosumab on BMD in elderly women with postmenopausal osteoporosis was conducted. According to bone densitometry, the efficacy of treatment has been demonstrated for all terms of the study, starting at 6 months.
denosumab, women, mineral density of bone tissue, osteopenia, osteoporosis
«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 207-210 pages, index UDK 615.038-616-08-039.73.71-007.234
