Romosozumab: A new anabolic arrow in quiver for management of osteoporosis

The multifactorial disease of the elderly, characterized by accelerated bone loss and a high risk of fracture (even with trivial trauma), osteoporosis, is known to primarily affect postmenopausal women. Moreover, the precipitating factors for the same mainly are the hormonal and nutritional deficiency. Clinically, the most common fracture to be encountered is the vertebral compression fracture. Apart from exogenously supplementing calcium and Vitamin D, a diverse group of drugs (bisphosphonates, denosumab, teriparatide, strontium ranelate, raloxifene, and calcitonin) are available to manage the case of osteoporosis. The latest drug to be approved and included in this quiver is a sclerostin-targeting monoclonal antibody, romosozumab. This new drug appears to be promising in managing the postmenopausal patients of osteoporosis. Although the array of adverse effects is not well recognized, a black box warning has been issued for this drug in reference to contraindicated use in patients with comorbid myocardial infarction. The intent of the authors for this review is to discuss the pharmacological profile of romosozumab, with particular emphasis on supportive clinical trials as well as the adverse drug reactions associated with its use.