Men's Osteoporosis Support GroupDenosumab for osteoporosis update J Clin Endocrinol Metab. 2008 Apr 1. [Epub ahead of print], Effects of Denosumab on Bone Mineral Density and Bone Turnover in Postmenopausal Women. Bone HG and others. PMID: 18381571. There is a previous Update on this medication that explains its method of action that you might find helpful. Basically Denosumab blocks the formation of osteoclasts which break down bone, thus allowing osteoblasts to form bone, with a net increase in bone mineral density (BMD). The study group included 332 postmenopausal women with lumbar spine BMD T-scores between -1.0 and -2.5. This means they were either osteoporotic or had osteopenia. Test subjects received two 60-mg injections per year. After two years the results showed that postmenopausal women receiving denosumab had significantly increased lumbar spine BMD compared with placebo at 24 months (6.5% vs -0.6%; P<0.0001). Denosumab also produced significant increases in BMD at the total hip, 1/3 radius, and total body (P<0.0001 vs placebo); increased distal radius vBMD (P<0.01); improved HSA parameters; and significantly suppressed serum CTX, TRAP-5b, and P1NP with similar incidence of adverse events compared to placebo. The authors conclude: "Twice-yearly denosumab increased BMD and decreased BTMs in early and later postmenopausal women." Editor's comments: Denosumab is still in clinical trials, but so far those trials have been positive. As always, the trials have all been on postmenopausal women, but there is no reason to suspect that denosumab won't be equally as effective for men since its method of action is not gender-specific. The key will be if future clinical trials continue to show the benefits of increased BMD without any significant side effects. If so, this medication will be a welcome addition to the arsenal of medications effective in treating osteoporosis. The twice-yearly dosing will be especially convenient, plus this will offer an alternative to the bisphosphonates for those concerned about their side effects. Check the related articles at PubMed for additional denosumab studies.
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