Saag KG, McDermott MT, Adachi J, et al. - Denosumab discontinuation in rheumatoid arthritis (RA) patients taking glucocorticoids (GCs) was shown to cause a gradual increase in bone turnover, which was related to a return to baseline lumbar spine (LS) and total hip (TH) bone mineral density (BMD).

• In this randomized, double-blind, placebo-controlled phase 2 study, changes in bone turnover and BMD were assessed in RA patients on GC post-discontinuing denosumab for 12 months.

• Patients were treated with placebo, or denosumab 60 or 180 mg every 6 months for 12 months.

• Significant reduction in C-terminal telopeptide of type I collagen (CTX) and procollagen type I N-terminal propeptide (P1NP) from baseline was evident in both denosumab groups.

• Post-denosumab cessation, CTX returned to baseline and was not significantly different from placebo 6 and 12 months post-cessation.

• For P1NP, median percent alterations from baseline with denosumab 60 mg were -0.16% and 15.3% at 6 and 12 months, respectively, post-discontinuation; and 9.0% and 75.8% with denosumab 180 mg.

• Relative to placebo, an increase in LS and TH BMD was evident in those taking denosumab, and return to baseline was seen 12 months post-discontinuation.