Efficacy of denosumab in two cases with multiple-system atrophy and osteoporosis

Figures & data

Figure 1 Percentage changes in lumbar BMD (A) and total hip BMD (B) before, and at 6–8, 12, 18, and 24 months after denosumab therapy.

Note: Patient 2 was followed up for 18 months, not 24 months.
Abbreviations: BMD, bone mineral density; M, months.

Figure 2 Percentage changes in BAP (A), urinary NTX (B), serum TRACP-5b (C), and active form of vitamin D or 1,25(OH)₂D₃ (D) before, and at 1, 4, 8, 12, 18, and 24 months after denosumab therapy.

Note: Patient 2 was followed up for 18 months, not 24 months.
Abbreviations: BAP, bone alkaline phosphatase; NTX, cross-linked N-terminal telopeptides of type I collagen; TRACP-5, tartrate-resistant acid phosphatase 5b; M, months.

Table 1 Patient laboratory data

	Serum Alb (g/dL)							Serum Ca (mEq/L)							Serum P (mg/dL)							Serum whole PTH (pg/mL)
	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M
Patient 1	4.1	4.0	4.0	3.7	3.8	4.0	3.9	9.3	9.1	8.8	9.0	9.1	8.9	9.0	3.6	3.2	2.6	2.9	2.9	2.8	2.6	23.4	39.5	19.1	17.9	15.1	13.5	16.1
Patient 2	3.9	3.8	4.0	4.0	3.9	3.8		9.2	8.3	9.3	9.4	9.2	9.3		4.1	3.6	4.1	4.9	5.1	4.1		18.2	33.4	40.7	20.1	21.0	12.0

Note: Patient 2 was followed up for 18 months, not 24 months.

Abbreviations: Alb, albumin; PTH, parathyroid hormone; M, months.

Table 2 Patient bone mineral density

	Height (cm)	Weight (kg)	BMI (kg/m^2)	Lumbar BMD (g/cm^2)					Lumbar BMD T score					Total hip BMD (g/cm^2)					Total hip BMD T score
				Before	6–8 M	12 M	18 M	24 M	Before	6–8 M	12 M	18 M	24 M	Before	6–8 M	12 M	18 M	24 M	Before	6–8 M	12 M	18 M	24 M
Patient 1	185	92.0	26.9	1.071	1.112	1.114	1.071	1.109	−0.9	−0.6	−0.5	−0.9	−0.6	0.933	0.948	0.951	0.956	0.939	−0.05	0.05	0.1	0.1	−0.05
Patient 2	156	49.6	20.4	0.728	0.779	0.782	0.803		−3.2	−2.8	−2.7	−2.6		0.685	0.724	0.722	0.707		−2.1	−1.7	−1.8	−1.9

Note: Patient 2 was followed up for 18 months, not 24 months.

Abbreviations: BMI, body mass index; BMD, bone mineral density; M, months.

Table 3 Patient laboratory data (bone metabolism markers)

	BAP (μg/L)							Urinary NTX (nmol BCE/mmol Cr)							TRACP-5b (mU/dL)							1,25(OH)2D3 (ng/mL)
	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M	Before	1 M	4 M	8 M	12 M	18 M	24 M
Patient 1	15.1	12.6	8.3	8.9	9.0	9.4	8.1	26.4	14.9	17.4	9.7	16.2	10.6	19.1	526	172	263	184	292	310	257	42.9	1 14	61.1	50.7	44.1	63.8	84.8
Patient 2	14.7	17.8	8.4	7.7	10.4			59.5	18.0	15.9	8.7	51.6			613	122	127	113	354			38.3	98.9	43.2	74.9	49.8

Note: Patient 2 was followed up for 18 months, not 24 months.

Abbreviations: BAP, bone alkaline phosphatase; NTX, cross-linked N-terminal telopeptides of type I collagen; TRACP-5b, tartrate-resistant acid phosphatase 5b; M, months.