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Clinical debate: Short- or long-term denosumab therapy?
Friday, May 13, 2022 · 2:02 p.m. · 11m 35s
Dr. J. Everts-Graber (Bern) & Pr. Dr. S. Ferrari (GVA)
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00:00:01
yes say thank you very much very interesting to you showed a and i think a
00:00:06
with their p. m. t. able tension i said only when we continued in all the map
00:00:10
we can piece yeah but even increase to begin d. that would be an argument for red
00:00:16
channels and that definitely or journals not lifelong i mean we hear a lot of bad nowadays
00:00:22
and yes i mean ease that treatment options some patients at denny's
00:00:26
we cannot switch to yeah to play baseball alternate freaks opportunity renal failure
00:00:33
but in all the other ones i have to say ninety five percent
00:00:38
off the patient into freedom expansion tried reached totally score
00:00:42
of mine is one point five within ten days of therapy
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so i don't know the map lifelong i have to ask the heretical question do we
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continue doesn't apply front because we had get incidentally or
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is it just a very comfortable thing to do just asking
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or uh i told you agree with you to do we continue
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peaceful also may be on three years because we are very good
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detail because it's a it's a good thing to do i mean reminded that the pain yours the map is the longest and largest
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a trial with any drug in a stupor with these with these false on it yeah because for long times less than that
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well i guess we do not disagree if it's
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agreeable and high risk patients deserve longterm journalism of therapy
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and that the shortage re should uh use perhaps an option uh four goals will quickly reach that
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target than are rather low risk always know fractures and we agree if good and okay yeah i
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i would have liked to think suggestions from the audience
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um you know uh i i'd like to comment of course
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of a few ought to the provincial sector or not but um
00:02:02
i don't like the term long term a treatment push tunnels of that because i
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don't think there is really evidence for this to preach ten years and then switch
00:02:14
to everything because we don't have any data on this and so far what doc you too
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two two you've the the tone longterm treatment to and this treatment
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and uh i totally agree that's the high risk patients are
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very high risk patients you don't stop to know some up
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it
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so i mean when we look at the anti fact yeah no it's just that one
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thing i want to say about it the short term then also not therapy he said
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does it make sense to treat patients with notes kept low t. scores
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and the moderate factories with a with the first line shorts terminals map therapy
00:02:59
i i think you're right it's probably nowadays really treated with that's possibly but
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you have to see this in the light of to history twelve years ago
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doesn't that was approved in switzerland and every fixation can described and also
00:03:11
not in the spaces with osteoporosis or of for the prevention of bone loss
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and we will all they're excited so bad taste and it was
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so so simple to start it so well tolerated for my patients adults
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he'll venice for every band affected it was not the title of these ago so we thought okay it's just
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the therapy with a trance in treatment effect as we
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can it serve it with s. vigilance paramilitary power chad
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but you know that the thing with the increase the vertebral fractures off does continuation this
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came up in two thousand seventeen eighteen i guess so sixteen i'm sorry fast so i think
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this may be changed meanwhile that we
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probably treat patients probably 'cause fascinates than with
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the short and then also map they repeat who has not very lonely t. scores
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i do not disagree with that that has changed approaches a little bit
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but nevertheless tritium was peaceful soul mates we know that
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we have beneficial effects for about three years and after that is the maintenance of the benefits
00:04:18
but more for improving ball mastering temperature adoption older studies i only needed so that's where
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the problem was getting is false when it's too soon after initiating the nulls him um
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because then i know that the minute i give it i sort of limits my ambition
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to be if you can prove balls functional spatial that that's look better
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yeah let me just and saying to for false is nice presentations
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probably is a good question is not our longer uh ease
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of good deflation posted as you mob but how to manage
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so a rebound effect extract why if we
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haven't any our rebound effect we can give a
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along down there as you model without any program expanding probably we have
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to give a very i do is use of the first one it's
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uh to avoid a rebound effect them proper business strategy is
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not the same if we they care two years the map
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or ten years to matter that's what i shaved i actually
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agree with that but then also you guys should be between your
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of of the visual study that those previously on peaceful so nate they're very low
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risk of fracture stopping him up and probably those can go on long term therapy
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without any problem and forty orders yes so to me the longer we treat the more peaceful
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so it would need off about yes it means and why and one's own will do the job
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but again we're not talking here you know the idea to say we're gonna do a show to therapy
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because it makes all life as a doctor simpler
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when we stop the therapy we're thinking about all selves
00:06:00
making life easier with go off to the most about their appeal would not think about the patient
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i disagree i'm i'm i'm not i tried to get presentation wrote
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me an email and you asked me not to separate out the revenge
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now i did apparently and i'm sorry but it's like i don't want you
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you know all the treatment benefits they are i think they are a yeah it we don't have to discuss that but
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all i'm saying is i have to take every bad into account when
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we it says that the final or deny effectiveness of panels and it's like
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when you buy a big huge expensive car you should
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also think attached to service calls stopped if anything with with
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long term than ours unhappy yes we can do we but we should consider just it's cost yeah caught most i light
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like big huge and so on
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yeah thank you and you showed that professor for are you showed that half
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of the fractures happen in a still panic patients that was the discussion on
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promises that the this continuation so why continue for long term then does
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it matter that in a patient who had a fracture on a um
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in a state of panic situation wide romans assume that that we could
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get just one here from o. one year and then two years perfect treatment
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this the bait does not take roman consideration of i agree no
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no no that's not why not that's a good meeting two years
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because there's everything actually ah one to address the to put a big factor whitehorse two years i've
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been on the market there is just opinion and then we stopped and we know that we keep
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the d. m. v. which is the target country where the playboy thing would be to start
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well when you're in those arms patients get in the malls about two years which is equivalent to
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what you don't like eight or ten years of continues the knows
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about therapy joplin three years and then we still need to consolidate of
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course and and we don't really have experience in that context of how much sort will take about the about willow all from that yep
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right for one or two short questions
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or physical record
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okay
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most of by patients have a life expectancy
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we shoes rather short so if i can tell them you go on with
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your treatment without thinking about how long it will go there are very satisfied
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thank you we had a question i'm not talk that i'm not talking about
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patient lark with eighty two easel you rolled at i'm talking about when you
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cool web it fixed it to wait another apple started i mean we have saved think if if it could dictate if take a
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i guess we may extrapolate to healthy thirty's not twenty sure he's i well i'm
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reluctant with that but i think we were from patients will
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build hobble twenty five euros applies expectancy right if shorter than that
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that was exactly my point that many patients started
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treating two hundred fifty five sixty or sixty five
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and they may have a life expectancy for twenty maybe twenty five or thirty years
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and if they're on the now some up we need to have a sequential therapy regimen
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to treat them i don't think we can teach them for twenty five or thirty years i simply don't and will never have to data
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uh i don't think anyone of us i thought anyway right but
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but that's the point i mean if we start treating them ten years
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we need to and answer the question can we treat them fifteen use can we teach them twenty years
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i think it's not really the question if we treat them two or five or seven years that's also what the question
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but the big question is if we treat them long term it's like what's up pops it
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is a lifelong or is it not lifelong and it's my opinion that it shouldn't be lifelong
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if the life expectancy is a lot more than ten or fifteen
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years i've been we need sequel e. meet sequential treatment there is
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may i suggest that we should move away from this
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use less discussion of how long to treat than just
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tuning device approach as you mentioned were by the duration
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of therapy depends on your starting point and your treatment target
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and the target is gonna be different of course you know fifty five year old doesn't fall
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when a seventy five reward for the rebate the minus one point
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five t. score target that we happen may be hard to reach
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with long term you would we don't don't ought be be suitable for
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the seventy five year old that the fall three times or your because of
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the high risk of exposed gossip about my fifty five i agree maybe
00:11:03
two years she's of minus two five or risk is not that big anymore
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so targets might be adapted unusual therapy at that to to target and the patient
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lot than than decided it should be to
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five ten fifteen twenty because over doesn't mean anything
00:11:22
i agree with many things to post both on ah many sounds for the cars
Conference Program
Introduction
Pr. Dr. S. Ferrari, Geneva
May 13, 2022 · 11:45 a.m.
Romosozumab clinical data
Pr. Dr. B. Langdahl, Aarhus, DK
May 13, 2022 · 11:50 a.m.
118 views
Romosozumab limitation (CH): challenges and opportunities
Pr. Dr. S. Ferrari, Geneva
May 13, 2022 · 12:25 p.m.
Questions & Answers Session
May 13, 2022 · 12:40 p.m.
Short- or long-term denosumab therapy? Part 1
Dr. J. Everts-Graber, Bern
May 13, 2022 · 1:37 p.m.
401 views
Short- or long-term denosumab therapy? Part 2
Pr. Dr. S. Ferrari, Geneva
May 13, 2022 · 1:52 p.m.
Clinical debate: Short- or long-term denosumab therapy?
May 13, 2022 · 2:02 p.m.
113 views
