Denosumab is a human monoclonal antibody to the receptor activator of nuclear factor-kappa B ligand (RANKL). Denosumab blocks binding of RANKL to RANK - inhibits development and activity of osteoclasts, decreases bone resorption, increases density.
RANK, also known as TRANCE Receptor, is a type I membrane protein that is expressed on the surface of osteoclasts and is involved in the activation of osteoclasts upon ligand binding. RANK is also expressed on dendritic cells and facilitates immune signaling. RANK ligand is found on the surface of osteoblasts, and T cells.
RANKL (Receptor Activator for Nuclear Factor κ B Ligand) is also known as TNF-related activation-induced cytokine (TRANCE).
Denosumab given SC twice yearly reduced risk of vertebral, nonvertebral, and hip fractures in women with osteoporosis. Denosumab reduced bone resorption by 86% at 1 month - greater than the reductions seen with other antiresorptive drugs http://bit.ly/Jgx2G
Denosumab increased bone density, decreased fractures among men receiving androgen-deprivation therapy for prostate CA http://bit.ly/EQm3R
The Food and Drug Administration on June 1, 2010 approved the sale of Amgen’s osteoporosis drug Prolia (denosumab) to help prevent fractures in postmenopausal women.
CTX and NTX are new markers of bone resorption used to diagnose osteoporosis and assess effect of bisphosphonate therapy
Once-a-Year Drug to Treat Osteoporosis
It is reasonable to stop bisphosphonates after 5 years of use and then to follow patients with markers of bone turnover http://goo.gl/YmNS9
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