4.5 Drug treatment for osteoporosis: Denosumab
Denosumab is another anti-resorptive but as a human monoclonal antibody, has a different mechanism of action from the bisphosphonates. Denosumab was launched in 2010 for the treatment of osteoporosis. The cells that make osteoclasts have receptors on their surface called RANK (receptor activator of nuclear factor-kappa B), which promotes the development of mature osteoclasts. It is the ligand to this which is inhibited by denosumab, thereby reducing bone loss.
Patients are given 60mg subcutaneously every 6 months. The most common side effects are joint and muscle pain in the arms or legs. There is an increased risk of infections such as cellulitis of hypocalcemia (low blood calcium) and hypersensitivity allergy reactions. There is also, as with bisphosphonates, a very small risk of atypical femoral fractures and osteonecrosis of the jaw (ONJ).
4.4 Quiz 3