La inhibición del RANKL en el tratamiento de la osteoporosis: denosumab

Abstract

Denosumab is a human monoclonal antibody IgG2 against RANKL that prevents the coupling of the RANKL with its receptor RANK on osteoclast and osteoclast precursors, which is essential for the formation, activity and survival of osteoclasts, disabling the bone resorption. The action of the Denosumab on bone remodeling is rapid, sustained and reversible. The recommended dose is of 60 mg for subcutaneous route every 6 months. The reduction of the relative risk of new vertebral fractures is of 68% (2.3% vs 7.2%, p < 0.0001), 20% (6.5% vs 8.0%) in non vertebral fractures and 40% (0.7% vs 1.2%) in the case of the of hip. At 36 months the lumbar bone mineral density increased 9.2% and 6.2% in the total hip, in comparison with the placebo. It is a safe drug with a low incident of cutaneous effects. The frequency and route of administration can be useful to improve the compliance of the osteoporosis treatment.