Anorexia nervosa is a serious mental health disorder characterized by a distorted body image and an intense fear of gaining weight. Individuals with anorexia nervosa often engage in extreme behaviors to control their weight and may experience physical and psychological complications as a result. Anorexia nervosa causes low bone mineral density (BMD), high bone resorption, and an increased risk of fractures.
A clinical trial was conducted to see if off-label antiresorptive therapy with denosumab can increase BMD in women with anorexia nervosa. The research involved 30 women with anorexia nervosa who were able to walk and had low bone density at one or more sites. They were divided into two groups and given either denosumab or a placebo for one year.
The primary endpoint was postero-anterior (PA) lumbar spine aBMD (Areal Bone Mineral Density) measured by dual-energy x-ray absorptiometry. Secondary endpoints included femoral neck aBMD, tibia and radius volumetric BMD and bone microarchitecture by high-resolution peripheral quantitative CT, tibia and radius failure load by finite element analysis (FEA), and markers of bone turnover.
The results of the study showed that antiresorptive therapy with denosumab increased spine aBMD in women with anorexia nervosa. The mean increase in PA lumbar spine aBMD was 5.5% in the denosumab group compared to 2.2% in the placebo group. There was no significant difference in the change of femoral neck aBMD between the two groups.