Efficacy of denosumab therapy for a 21-year-old woman with Prader-Willi syndrome, osteoporosis and history of fractures: a case report

Figures & data

Figure 1 Radiographs of posterior spinal correction surgery.

Notes: She underwent posterior spinal correction surgery for scoliosis at 12 years of age. Radiographs show (A) anterior-posterior view and (B) lateral view.

Table 1 Patient characteristics and the change of total hip bone mineral density

	Age (years)	Sex	BMI (kg/m^2)	Total hip BMD (g/cm^2)				Total hip T score
				Before	4M	8M	13M	Before	4M	8M	13M
Case	21	F	27.1	0.670	0.516	0.688	0.700	−2.3	−3.4	−2.1	−2.0

Abbreviations: BMD, bone mineral density; M, months; F, female.

Table 2 Patient laboratory data

	Before	1M	3M	6M	10M	13M
Alb	4.5	4.5	4.6	4.4	4.6	4.6
Ca	9.4	9.0	9.5	9.8	9.3	9.5
P	3.6	3.0	3.5	4.2	3.6	3.5
BAP	14.6	8.9	6.8	9.5	6.8	8.4
PINP	40.6	18.4	11.7	28.5	14.6	19.1
NTX	174	163	41	271	124	255
TRACP-5b	233	56	70	205	85	182
1,25(OH)2D	72.6	75.4	55.8	34.7	78.8	61.4
Whole PTH	19.2	39.0	32.1	19.1	35.7	28.8

Abbreviations: Alb, albumin; Ca, calcium; P, phosphorus; BAP, bone-specific alkaline phosphatase; PINP, type I procollagen N-terminal propeptide; NTX, type I collagen amino-terminal telopeptide; TRACP-5b, tartrate-resistant acid phosphatase 5b; 1,25(OH)2D, 1-alpha, 25-dihydroxyvitamin D3; PTH, parathyroid hormone; M, months.

Figure 2 The change of bone turnover markers.

Notes: Serum TRACP-5b and urinary type I collagen amino-terminal telopeptide greatly decreased after the first administration. Serum bone-specific alkaline phosphatase and type I procollagen N-terminal propeptide decreased as well, while the whole-parathyroid hormone and 1-alpha, 25-dihydroxyvitamin D3 increased.
Abbreviations: BAP, bone-specific alkaline phosphatase; PINP, type I procollagen N-terminal propeptide; NTX, type I collagen amino-terminal telopeptide; TRACP-5b, tartrate-resistant acid phosphatase 5b.

Figure 3 The change of bone mineral density (BMD).

Notes: At 13 months of denosumab treatment, her total hip BMD T-score improved from −2.3 to −2.0, and the BMD increased by 4.5% for total hips at the end of our study. The change of femoral neck BMD was also similar.