Denosumab: A new therapy for osteoporosis
Denosumab is a fully human monoclonal antibody that targets RANKL (receptor activator for nuclear factor κB ligand). RANKL is a key mediator of osteoclast activity. It aids to reduce the fracture risk and improved bone mineral density.
Every 6 months, this drug is subcutaneously administered that decreases bone resorption by inhibiting the formation and activity of osteoclasts, increases bone mineral density (BMD), reduces the risk of vertebral fracture by 70% and hip fracture by 40%.
Osteoporosis results from the reduced bone strength and predisposes patients to an increased risk of fracture. It is currently approved for use in postmenopausal women at risk for osteoporosis and prevent fractures associated with malignancies. Moreover, some studies have found that denosumab can be used safely and effective in treating moderate to severe impairment of renal functions. Additionally, anti-fracture activity of denosumab is equal to zoledronic acid, even no residual effect was found at beyond 6 months.
Denosumab represents a novel potential treatment option for the prevention of osteoporosis. These new treatments for osteoporosis may offer advantages over existing oral bisphosphonates. However, denosumab is reimbursed as a second-line treatment after a first attempt with bisphosphonate.