Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report
Hypophosphatasia is a rare inherited metabolic disease leading to inhibition of bone and teeth mineralization that can be complicated by multiple insufficiency fractures. Treatment is currently limited to enzyme replacement therapy using bone-targeting recombinant human alkaline phosphatase, or asfo...
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Elsevier
2024-10-01
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| Series: | Trauma Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644024001006 |
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| author | Pierre-Emmanuel Schwab Alicia Dessain Joshua Milby |
| author_facet | Pierre-Emmanuel Schwab Alicia Dessain Joshua Milby |
| author_sort | Pierre-Emmanuel Schwab |
| collection | DOAJ |
| description | Hypophosphatasia is a rare inherited metabolic disease leading to inhibition of bone and teeth mineralization that can be complicated by multiple insufficiency fractures. Treatment is currently limited to enzyme replacement therapy using bone-targeting recombinant human alkaline phosphatase, or asfotase alfa. Romosozumab is a monoclonal anti-sclerostin antibody originally indicated for the treatment of osteoporosis in postmenopausal women with high-risk of fracture. Recently its indication had been expanded to other metabolic bone disorders such as osteogenesis imperfecta. We report a unique case of a 67-yer-old female with hypophosphatasia complicated by multiple delayed-union and nonunion insufficiency fractures of the pelvis. After 12-month therapy with Romosozumab to address her osteoporosis, the patient healed her fractures and increased her bone mass density. Our case report shows interesting effects of Romozumab in an adult patient with hypophosphatasia. It not only helped increase bone density, but also help in the healing process of delayed-union and nonunion insufficiency fractures of the pelvis and prevented the occurrence of new fractures during the treatment period. To our knowledge, this is the first report describing the potential effect of Romosozumab on insufficiency fractures in patients with hypophosphatasia. |
| format | Article |
| id | doaj-art-413ac4e9bb3c40a0818e28fa2ba8d9f9 |
| institution | Kabale University |
| issn | 2352-6440 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj-art-413ac4e9bb3c40a0818e28fa2ba8d9f92025-08-20T03:46:58ZengElsevierTrauma Case Reports2352-64402024-10-015310107710.1016/j.tcr.2024.101077Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case reportPierre-Emmanuel Schwab0Alicia Dessain1Joshua Milby2Missouri Orthopaedic Institute, Missouri University Health, Department of Orthopaedic Surgery, 1100 Virginia Avenue, Columbia, MO 65201, United States of America; Corresponding author.Missouri University Health, Department of Pathology, 1 Hospital Drive, Columbia, MO 65201, United States of AmericaCox Medical Center South, Missouri University Health, Department of Orthopaedic Trauma Surgery, 3801 S National Avenue, Springfield, MO 65807, United States of AmericaHypophosphatasia is a rare inherited metabolic disease leading to inhibition of bone and teeth mineralization that can be complicated by multiple insufficiency fractures. Treatment is currently limited to enzyme replacement therapy using bone-targeting recombinant human alkaline phosphatase, or asfotase alfa. Romosozumab is a monoclonal anti-sclerostin antibody originally indicated for the treatment of osteoporosis in postmenopausal women with high-risk of fracture. Recently its indication had been expanded to other metabolic bone disorders such as osteogenesis imperfecta. We report a unique case of a 67-yer-old female with hypophosphatasia complicated by multiple delayed-union and nonunion insufficiency fractures of the pelvis. After 12-month therapy with Romosozumab to address her osteoporosis, the patient healed her fractures and increased her bone mass density. Our case report shows interesting effects of Romozumab in an adult patient with hypophosphatasia. It not only helped increase bone density, but also help in the healing process of delayed-union and nonunion insufficiency fractures of the pelvis and prevented the occurrence of new fractures during the treatment period. To our knowledge, this is the first report describing the potential effect of Romosozumab on insufficiency fractures in patients with hypophosphatasia.http://www.sciencedirect.com/science/article/pii/S2352644024001006HypophosphatasiaAnti-sclerostin antibodyRomosozumabInsufficiency fractureNonunionDelayed union |
| spellingShingle | Pierre-Emmanuel Schwab Alicia Dessain Joshua Milby Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report Trauma Case Reports Hypophosphatasia Anti-sclerostin antibody Romosozumab Insufficiency fracture Nonunion Delayed union |
| title | Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report |
| title_full | Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report |
| title_fullStr | Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report |
| title_full_unstemmed | Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report |
| title_short | Monoclonal antibody anti-sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia: A case report |
| title_sort | monoclonal antibody anti sclerostin for treatment of pelvic insufficiency fractures in adult hypophosphatasia a case report |
| topic | Hypophosphatasia Anti-sclerostin antibody Romosozumab Insufficiency fracture Nonunion Delayed union |
| url | http://www.sciencedirect.com/science/article/pii/S2352644024001006 |
| work_keys_str_mv | AT pierreemmanuelschwab monoclonalantibodyantisclerostinfortreatmentofpelvicinsufficiencyfracturesinadulthypophosphatasiaacasereport AT aliciadessain monoclonalantibodyantisclerostinfortreatmentofpelvicinsufficiencyfracturesinadulthypophosphatasiaacasereport AT joshuamilby monoclonalantibodyantisclerostinfortreatmentofpelvicinsufficiencyfracturesinadulthypophosphatasiaacasereport |