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A new antiresorptive approach to the treatment of fragility fractures: long-term efficacy and safety of denosumab

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Abstract

An imbalance of the remodeling process for bone resorption leads to a loss of tissue with consequent microarchitectural damage, evident in conditions such as osteoporosis and related fragility fractures. Currently, pharmacological therapies are able to prevent or slow down bone resorption by inhibiting osteoclast activity. An innovative and targeted anti-resorptive approach is represented by the inhibition of RANK ligand (RANK-L), essential for the proliferation and activity of osteoclastic cells. The human monoclonal antibody against RANK-L (denosumab) has been approved for the treatment of osteoporosis. In clinical trials of patients with osteoporosis, inhibition of RANK-L has reduced bone loss and damage to the microarchitecture and was associated with an increase in mass and resistance at different skeletal sites, with most significant effects than those demonstrated by any other antiresorptive drugs. In addition, after 3 years of treatment, it showed a reduction in vertebral and non-vertebral fracture risk. Denosumab treatment also has not revealed any alteration in the physiological processes of fracture repair, showing no increase in the onset of complications 3 years after the fracture. The data show that denosumab offers an effective alternative therapeutic approach for the treatment of severe osteoporosis, with positive effects on BMD and reduction of fragility fractures risk. So, promising results in terms of therapeutic efficacy and reliability make desirable the wide clinical use of denosumab for the treatment of osteoporotic fractures in the near future.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University of Rome “Tor Vergata”, “Policlinico Tor Vergata” Foundation, V.le Oxford 81, 00133, Rome, Italy

    Umberto Tarantino, Monica Celi, Maurizio Feola & Federico Maria Liuni

  2. Centre for the Study of Osteoporotic and Metabolic Bone Disease, Section of Orthopedic and Traumatology, Treviglio-Caravaggio Hospital, Bergamo, Italy

    Giuseppina Resmini

  3. Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy

    Giovanni Iolascon

Authors
  1. Umberto Tarantino
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  2. Monica Celi
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  3. Maurizio Feola
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  4. Federico Maria Liuni
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  5. Giuseppina Resmini
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  6. Giovanni Iolascon
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Correspondence to Umberto Tarantino.

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Tarantino, U., Celi, M., Feola, M. et al. A new antiresorptive approach to the treatment of fragility fractures: long-term efficacy and safety of denosumab. Aging Clin Exp Res 25 (Suppl 1), 65–69 (2013). https://doi.org/10.1007/s40520-013-0082-1

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  • DOI: https://doi.org/10.1007/s40520-013-0082-1

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