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. 2023 Dec 10;57(Suppl 1):127-134.
doi: 10.1007/s43465-023-01064-5. eCollection 2023 Dec.

Biologic Antiresorptive: Denosumab

Lalit Kumar  1 , Mohit Kumar Arora  1   2 , Sunil Marwah  1   2
Affiliations

Biologic Antiresorptive: Denosumab

Lalit Kumar et al. Indian J Orthop. .

Abstract

Background: Osteoporosis is an age-related common bone disorder characterized by low bone mineral density and increased fragility fracture risk. Various Antiresorptive medications are being used to target osteoclast mediated bone resorption to prevent bone loss and reduce fracture risk.

About denosumab: Denosumab is a novel biological antiresorptive drug that belongs to the class of monoclonal antibodies. It binds to and inhibits the cytokine receptor activator of nuclear factor kappa-B ligand (RANKL), which is requisite for osteoclast differentiation, function and survival.

Effectiveness: Denosumab has been shown to be a potent and effective therapy for osteoporosis, with clinical trial data demonstrating significant improvement in bone mineral density (BMD) and reductions in fracture risk at various skeletal sites for more than 10 years of treatment.

Safety profile: Denosumab has a favourable benefit/risk profile, with low rates of complications such as infection, atypical femoral fracture and osteonecrosis of the jawbone.

Challenges: However, denosumab treatment requires continuous administration, as discontinuation leads to rapid bone mineral loss and increased risk of multiple vertebral fractures due to rebound of bone turnover. Therefore, modification to another anti-osteoporosis drug therapy after denosumab discontinuation is required to maintain bone health.

Conclusion: Denosumab is a promising biological antiresorptive therapy for osteoporosis that offers high efficacy and safety, but also poses challenges for long-term management.

Keywords: Antiresorptive; Biologic; Denosumab; Monoclonal antibody; Osteoporosis treatment.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

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