Bone turnover rebounds when a denosumab dose is late, and rapid bone loss and multiple vertebral fractures can follow within months. The risk comes from delay as well as deliberate stopping.
Book the next injection at the time of each dose, flag the due date in the record, and give the patient the date in writing. If a dose will be more than a few weeks late, plan a bridge.
- Book the next denosumab dose at every injection.
- Keep a register of patients on denosumab with due dates.
- Contact patients whose dose is overdue.
- Never stop denosumab without a follow-on plan.
Why it matters
Late or missed denosumab doses cause rebound vertebral fractures that are entirely preventable.
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