Berks County Medical Society Medical Record Spring 2020 - 29

M e d i c a l R ec o r d F e a t u r e

Denosumab Superior
to Risedronate for
Protection Against
Glucocorticoid-Induced
Bone Loss

A

ll physicians who care for patients needing long-term
treatment with glucocorticoids should be aware of the
findings of a recent study comparing the efficacy of
denosumab (Prolia) and risedronate (Actonel) for protecting against
the bone loss associated with glucocorticoids. Denosumab was
superior to risedronate in all parameters of bone protection, and as a
result is now an approved therapy for this indication.
Taking just 10mg per day of prednisone for three months
increases the risk of osteoporotic bone fracture by a factor of 17. Too
often, rheumatologists are consulted to help manage patients only
after such fractures occur-fractures which may have been avoided.
Berks County is fortunate to be the home of Dr. Ronald Emkey,
who in 1998 coauthored the very first major study on the prevention
and treatment of glucocorticoid-induced osteoporosis.1 This study
demonstrated the efficacy of alendronate for this indication. The
following year he coauthored a study of risedronate which showed
that it, too, prevents bone loss from glucocorticoids.
Twenty years later, Dr. Emkey can look back on a prolific career
in both research and clinical care. He has played a leading role in
improving the ability of the medical community to prevent and treat
osteoporosis, with the study comparing denosumab to risedronate
for glucocorticoid-induced bone loss being the most recent2,3 of a
long line of published clinical trials. Dr. Emkey has been joined in
his practice and research activities by his son Dr. Greg Emkey, whom
he credits with doing much of the work on this latest study. Their
practice, Emkey Arthritis and Osteoporosis Clinic, was the largest
site in the U.S. for what was an international study-a testament to
the willingness of their patients to participate in advancing medical
knowledge.
The Berks County Medical Society is proud to count both Dr.
Emkeys as members, and wish them continued success.
Lucy J. Cairns, MD
Editor

1
ALENDRONATE FOR THE PREVENTION AND TREATMENT OF
GLUCOCORTICOID-INDUCED OSTEOPOROSIS. The New England Journal of
Medicine, Vol. 339, Number 5, July 30, 1998, Pgs. 292-299. Kenneth G. Saag, M.D.;
Ronald Emkey, M.D.; Thomas J. Schnitzer, M.D., Ph.D.; Jacques P. Brown, M.D.;
Federico Hawkins, M.D.; Stefan Goemaere, M.D.; Gorm Thamsborg, M.D.; Uri A.
Liberman, M.D., Ph.D.; Pierre D. Delmas, M.D., Ph.D.; Marie-Pierre Malice, Ph.D.;
Michelle Czachur, M.P.H.; Anastasia G. Daifotis, M.D.; for the Glucocorticoid-Induced
Osteoporosis Intervention Study Group.
2
DENOSUMAB VERSUS RISEDRONATE IN GLUCOCORTICOID-INDUCED
OSTEOPOROSIS:A MULTICENTRE, RANDOMIZED, DOUBLE-BLIND,
ACTIVE-CONTROLLED, DOUBLE-

DUMMY, NON-INFERIORITY STUDY. Published in The Lancet Diabetes &
Endocrinology, 06 April 2018. Prof Kenneth G Saag, MD, Rachel B Wagman, MD,
Prof Piet Geusens, MD, Prof Jonathan D Adachi, MD, Osvaldo D Messina, MD, Ronald
Emkey, MD, Prof Roland Chapurlat, MD, Andrea Wang, MA, Nicola Pannacciulli, MD,
Prof Willem F Lems, MD.
3
GREATER BMD GAINS WITH DENOSUMAB VS RISEDRONATE IN
GLUCOCORTICOID-TREATED SUBJECTS: RESULTS FROM THE FINAL
24-MONTH ANALYSIS OF A RANDOMIZED, DOUBLE-BLIND, DOUBLEDUMMY STUDY. Presented at the 2018 ACR in Chicago, IL. Kenneth Saag1, Nicola
Pannacciulli2, Piet Geusens3, Jonathan D. Adachi4, Osvaldo D.Messina5, Jorge MoralesTorres6, Ronald Emkey7, Peter W. Butler2, Xiang Yin2 and Willem F.Lems8, 1University
of Alabama at Birmingham, Birmingham, AL, 2Amgen Inc., Thousand Oaks,CA,
3Maastricht University, Maastricht, Netherlands, 4McMaster University, Hamilton,
ON,Canada, 5Cosme Argerich Hospital, Buenos Aries, Argentina, 6Hospital Aranda de la
Parra, Leon,Mexico, 7Emkey Arthritis & Osteoporosis Clinic, Wyomissing, PA, 8VU
University Medical Centre, Amsterdam, Netherlands

SPRING 2020

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Berks County Medical Society Medical Record Spring 2020

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