Denosumab
Denosumab, a new fully human monoclonal antibody targets and binds with high affinity and specificity to RANK ligand and prevents activation of RANK receptors found on osteoclast precursors and osteoclasts. Denosumab inhibits the development and activity of osteoclasts, decreases bone resorption and increases bone density. A study of 7868 women (60 to 90 years; mean 72 + 5.2) included 32% of women 75 years and over with bone mineral density confirmed osteoporosis with or without prevalent fractures. In the mixed age cohort, vertebral fractures were reduced by 61% at one year and 68% by three years (p < 0.001 for both). Non-vertebral fractures were reduced by 20% (HR 0.8; 95%CI 0.7–0.95; p = 0.01) and hip fractures were reduced by 40% (HR 0.6; 95%CI 0.4–0.97; p = 0.04) by three years.