Antistofbaseret behandling af osteoporose – Behandling af osteoporose med denosumab og romosozumab
Sammanfattning
Osteoporosis is treated with antiresorptive agents, which inhibit bone resorption or bone anabolic medicine that increase bone formation. Denosumab, a human monoclonal antibody against”receptor activator of nuclear factor kappa-β-ligand” (RANKL), is one of the most potent treatments of osteoporosis.
Treatment with denosumab increases bone mineral density (BMD) in the hip and lumbal spine, and decreases the risk of fractures. Denosumab is generally well tolerated, however, in rare cases long-term treatment might be associated with serious side effects (atypical femur fracture and osteonecrosis
of the jaw). When discontinuing treatment bone mass gained during therapy rapidly declines, thus at present treatment with denosumab is considered to be life long. Results from clinical trial indicate, that romosozumab has the potential to become a very effective treatment of osteoporosis. Romosozumab is a human monoclonal antibody against the protein sclerostin, and unlike denosumab, treatment with romosozumab has at the same time bone forming and antiresorptive effects on bone. Treatment increases BMD in the hip and lumbar spine and decreases fracture risk compared to placebo and compared to treatment with alendronate. Romosozumab is not yet licensed for the treatment of osteoporosis.