Evidence map›Paper›PMID 28580511›Full record

Observational studyOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

Effect of recent spinal cord injury on the OPG/RANKL system and its relationship with bone loss and the response to denosumab therapy.

L Gifre, S Ruiz-Gaspà, J L Carrasco, E Portell, J Vidal, A Muxi, A Monegal, N Guañabens, P Peris

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Denosumab for Prevention of Acute Onset Immobilization-Induced Alterations of Bone Turnover: A Randomized Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022
    Trial
  3. Review
  4. Review
  5. International Spinal Cord Injury Fracture History Extended Data Set.Topics in spinal cord injury rehabilitation · 2025
    Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

L GifreRheumatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
S Ruiz-GaspàCIBERehd, Barcelona, Spain.
J L CarrascoPublic Health Department, University of Barcelona, Barcelona, Spain.
E PortellGuttmann Neurorehabilitation Institute, Universitat Autònoma de Barcelona, Badalona, Spain.
J VidalGuttmann Neurorehabilitation Institute, Universitat Autònoma de Barcelona, Badalona, Spain.
A MuxiNuclear Medicine Department, Hospital Clínic of Barcelona, Barcelona, Spain.
A MonegalRheumatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
N GuañabensRheumatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
P PerisRheumatology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. pperis@clinic.ub.es.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESInstitut Guttmann · ESUniversitat de Barcelona · ESHospital Clínic de Barcelona · ESHospital Universitari Germans Trias i Pujol · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

There is marked bone loss after spinal cord injury (SCI); however, its pathogenesis and clinical management remain unclear. The increased circulating levels of receptor activator of nuclear factor kB ligand (RANKL) associated with bone loss shortly after SCI and the prevention of bone loss with denosumab treatment suggest a contributory role of RANKL in SCI-induced osteoporosis.

introductionBone turnover and bone loss are markedly increased shortly after SCI. However, the pathogenesis and clinical management of this process remain unclear, especially the role of the osteoprotegerin (OPG)/RANKL system in this disorder. The aim of this study was to analyze serum levels of OPG and RANKL in bone loss associated with recent SCI and the effect of denosumab treatment on these mediators.

methodsTwenty-three males with recent complete SCI were prospectively included. Serum OPG and RANKL levels, bone turnover markers (PINP, bone ALP, CTX), and bone mineral density (BMD) were assessed at baseline, at 6 months of follow-up, prior to initiating denosumab, and 6 months after treatment. The results were compared with a healthy control group.

resultsAt baseline, SCI patients showed higher RANKL levels vs. controls which were correlated with days-since-SCI and total hip BMD loss at 6 months. OPG levels were similar to controls at baseline. After denosumab treatment, OPG showed no changes, whereas RANKL levels became undetectable in 67% of patients. Patients with undetectable RANKL during treatment showed better response in femoral BMD and bone markers vs. patients with detectable RANKL at 6 months of denosumab. Increased parathormone (PTH) levels during treatment were negatively correlated with RANKL changes.

conclusionsRANKL levels are increased after SCI and related to BMD loss at the proximal femur, becoming undetectable after denosumab treatment. The effect of denosumab on preventing sublesional bone loss, especially in patients with undetectable levels during treatment, suggests a contributory role of RANKL in this process.

Indexed as

AdolescentAdultAgedBiomarkersBone DensityBone Density Conservation AgentsBone RemodelingDenosumabHumansMaleMiddle AgedOsteoporosisOsteoprotegerinProspective StudiesRANK LigandSpinal Cord InjuriesBiomarkersBone Density Conservation AgentsDenosumabOsteoprotegerinRANK LigandTNFRSF11B protein, humanTNFSF11 protein, humanDenosumabOPGOsteoporosisRank ligandSpinal cord injury

Identifiers

PMID28580511
OpenAlexW2621054087

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.