DAR No 2. Denosumab (Prolia®) for osteoporosis

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New mechanism but questionable efficacy

Denosumab is the first monoclonal antibody that binds to RANKL inhibiting its action and activating the RANK receptor on the surface of osteoclasts and other cells of the immune system.
Studies on the efficacy of denosumab compared to alendronate have only been carried out with surrogate measurements like the increase in bone density, which has limited value in predicting the risk of fracture.
The main uncertainty concerns long-term safety given its effects on the immune system.
Its price is higher than alendronate and risedronate.

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