Therapeutic Advances in Musculoskeletal Disease 12 2 journals.sagepub.com/home/tab prednisolone and gradually weaning off. She remains on azathioprine 100 mg BD. Discussion: We conclude that denosumab could be an option for the management of hypercalcae-mia of sarcoidosis if bisphosphonates are con-traindicated. More data are required to establish safety at variable degrees of renal impairment and to identify an optimal dose for this indication. Abstract ID: 74 Clinical presentation: An 82 year old male with history of T12 fracture, prostate cancer, inflam-matory arthritis, polymyalgia rheumatica on maintenance oral steroid (Prednisolone 2 mg od-stable dose) was referred to osteoporosis clinic in June 2016 with history of intolerance to oral bisphosphonate. Investigations: Vitamin D = 26 nmol/l DEXA scan: T-score of-1.9 (osteopenia) at femoral neck and T12 fracture on spinal morphometry. Management: There were no prior dental issues. Given prevalent clinical risk factors, following discussion, he received first IV Zoledronic acid infusion in July 2016. His second annual infusion was delayed due to findings of suppressed bone turnover marker (CTX 0.17 ug/L) with a plan to repeat his CTX 6 months later. In the interim, he presented to Maxillofacial (Maxfax) team where he was found to have developed an oro-antral communication (Figure 1) along the socket of the Upper Left premolar (UL5) region, which happened as two adjoining teeth spontaneously came out. He was treated with oral Fluconazole tablets and Nystatin mouth wash and was provided with a cover plate to aid full closure of this oro-antral communication. Further anti-resorp-tive treatment was discontinued at this point whilst he continued adequate Calcium and vitamin D supplement. As his fistula had considerably shrunk in size at subsequent Maxfax review, he was discharged to community dentists for regular review in June 2019.
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