Denosumab to Prevent High-Turnover Bone Loss After Bariatric Surgery

Open to people ages 25 years and up

• Postmenopausal women who are planning RYGB or SG surgery
• Men aged ≥ 50 years who are planning RYGB or SG surgery

• Prior bariatric surgery
• Weight = 400 lbs (due to limitations of bone imaging equipment)
• Renal disease
• Hypercalcemia or hypocalcemia
• Hypomagnesemia
• Serum 25-OH vitamin D (25OHD) < 20 ng/mL
• Hyperparathyroidism
• Liver disease (AST or ALT > 2 x upper normal limit)
• HCT < 32%
• History of malignancy (except basal cell carcinoma) in the past 1 year
• Significant cardiopulmonary disease
• Major psychiatric disease
• History of celiac disease or inflammatory bowel disease
• Excessive alcohol or substance abuse
• Paget's disease, primary hyperparathyroidism, or any other known congenital or acquired bone disease other than osteoporosis
• Current hyperthyroidism or use of levothyroxine with TSH < 0.1 uIU/mL
• Current use of loop diuretics
• Current use or use in the past 12 months of oral bisphosphonates or DMAB
• Current use or use within the past 3 months of SERMs or calcitonin
• Current use or use within the past 3 months of estrogen
• Use of testosterone therapy if dose has changed within the last 3 months, or if dose change or discontinuation is planned in the upcoming 18 months
• Any current or previous use of teriparatide, strontium, or any parenteral bisphosphonate
• Use of oral or parenteral glucocorticoids for more than 14 days within the past 6 months
• Extensive dental work involving extraction or dental implant within the past 2 months or planned in the upcoming 18 months
• DXA BMD T-score of < -3.0 at PA spine, total hip, or femoral neck
• Current use of anti-VEGF drug