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Denosumab: an Emerging Therapy in Pediatric Bone Disorders

  • Pediatrics (L Ward and E Imel, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Denosumab is an inhibitor of receptor activator of nuclear factor kappa-B ligand (RANKL), and has emerged as an important novel therapy for skeletal disorders. This article examines the use of denosumab in children.

Recent Findings

Considerable safety and efficacy data exists for denosumab treatment of adults with osteoporosis, bone metastases, and giant cell tumors. Pediatric data is limited; however, evidence suggests denosumab may be beneficial in decreasing bone turnover, increasing bone density, and preventing growth of certain skeletal neoplasms in children. Denosumab’s effect on bone turnover is rapidly reversible after drug discontinuation, representing a key difference from bisphosphonates. Rebound increased bone turnover has led to severe hypercalcemia in several pediatric patients.

Summary

Denosumab is a promising therapy for pediatric skeletal disorders. At present, safety concerns related to rebounding bone turnover and mineral homeostasis impact use of denosumab in children. Research is needed to determine if and how these effects can be mitigated.

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  1. Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Building 30 Room 228 MSC 4320, Bethesda, MD, 20982, USA

    Alison M. Boyce

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This research was supported by the Intramural Research Program of the National Institute of Dental and Craniofacial Research.

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This article is part of the Topical Collection on Pediatrics

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Boyce, A.M. Denosumab: an Emerging Therapy in Pediatric Bone Disorders. Curr Osteoporos Rep 15, 283–292 (2017). https://doi.org/10.1007/s11914-017-0380-1

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