Could Denosumab Support Bone Integrity in Sickle Cell Disease
Journal Title: Journal of Hematology & Thrombosis - Year 2015, Vol 1, Issue 2
Abstract
Sickle cell anaemia is a congenital disease characterized by painful vaso-occlusive crises. It is associated with vitamin D deficiency, osteoporosis and recurrent attacks of micro-infarctions lead to bone osteonecrosis. The most common sites of osteonecrosis in sickle cell disease are the femoral and humeral heads which could lead to severe pain and extensive physical disability. Denosumab is a new human monoclonal antibody product; it is a receptor activator of nuclear factor kappa B ligand RANKL. That decreases osteoclastic bone restoration. It is Food and Drug Administration FDA approved for osteoporosis for women with high risk of fracture; and it is also being used for the treatment and prevention of bone loss in patients undergoing hormone ablation therapy for breast and prostate cancer. Denosumab is not restricted for sickle cell disease patients within its approved indications. It has less nephrotoxicity effect than the bisphosphonates which is a big advantage for sickle cell patients. It also used as an adjuvant agent to reduce metastatic bone pain in solid tumors. The extension of Denosumab use for sickle cell patients’ osteoporosis and osteonecrosis deserve a randomized multi central trail aiming to improve bone integrity and possible reduction of the devastating pain in sickle cell disease patients.
Authors and Affiliations
Hassan Al-Jafar
Keywords
Related Articles
- EP ID EP246518
- DOI 10.13188/2380-6842.1000009
- Views 152
- Downloads 0
The Promise and Challenges of Personalized Medicine in Hematologic Malignancies
Personalized medicine is a rapidly emerging medical model that proposes individually customized healthcare to potentially increase the quality of clinical care and reduce health care costs. The key to the success of pers...
Kinase Mutations as Predictive Biomarkers in Hematolymphoid Malignancies
Targeted therapeutics against kinases has been employed in the clinic for over a decade. Their use of ten times requires concomitant molecular diagnostics evaluating the mutational status of the targeted kinases. While k...
Accidental and Surreptitious Intake of Oral Anticoagulants Including Older and Newer Agents - A Diagnostic Dilemma
The newer oral anticoagulants including dabigatran, rivaraxoban, apixaban and edoxaban are replacing warfarin in the management of atrial fibrillation and venous thromboembolism. Accidental and surreptitious overdose of...
Residual Clot in Patients with Deep Vein Thrombosis and Pulmonary Embolism: Prognostic Implications
In order to assess whether there is discordance in the timing of thrombus resolution between deep vein thrombosis (DVT) and pulmonary embolism (PE), we analyzed current evidence from recent major literature, and evaluate...
Effects of Heparin Therapy on Hexagonal Lipid Neutralization Test
In this retrospective study; we evaluate the effects of heparin therapy on hexagonal lipid neutralization test. We identified 8000 patients in our hospital system that had been evaluated for lupus anticoagulants. Among t...