Efficacy and safety of Romosozumab in treatment for low bone mineral density: a systematic review and meta-analysis

Kaveh, Sara; Hosseinifard, Hossein; Ghadimi, Nashmil; Vojdanian, Mahdi; Aryankhesal, Aidin

doi:10.1007/s10067-020-04948-1

Cited by 40 publications

(29 citation statements)

References 38 publications

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“…Meanwhile, SOST expression is increased in breast cancer with bone metastasis, and the SOST antibody is reported to effectively suppress bone metastasis in breast cancer [ 193 ]. A monoclonal antibody to SOST, romosozumab, is being used for osteoporosis treatment in clinical practice, and further study is needed in order to implement its use in breast cancer patients with bone metastasis [ 194 ].…”

Section: Therapeutic Targets Of Adipokines and Bmas For Bone Metasmentioning

confidence: 99%

The Role of Adipokines and Bone Marrow Adipocytes in Breast Cancer Bone Metastasis

Shin

Koo

2020

IJMS

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The morbidity and mortality of breast cancer is mostly due to a distant metastasis, especially to the bone. Many factors may be responsible for bone metastasis in breast cancer, but interactions between tumor cells and other surrounding types of cells, and cytokines secreted by both, are expected to play the most important role. Bone marrow adipocyte (BMA) is one of the cell types comprising the bone, and adipokine is one of the cytokines secreted by both breast cancer cells and BMAs. These BMAs and adipokines are known to be responsible for cancer progression, and this review is focused on how BMAs and adipokines work in the process of breast cancer bone metastasis. Their potential as suppressive targets for bone metastasis is also explored in this review.

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Section: Therapeutic Targets Of Adipokines and Bmas For Bone Metasmentioning

confidence: 99%

The Role of Adipokines and Bone Marrow Adipocytes in Breast Cancer Bone Metastasis

Shin

Koo

2020

IJMS

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“…In the latter study, side effects were even lower in the romosozumab group with the exception of atrial fibrillation [76]. A recent meta-analysis described an even lower cardiovascular risk in high-dose romosozumab treatment as compared to placebo [99]. In addition, a recent systematic review and meta-analysis concluded that the cardiovascular risk for elderly men and postmenopausal women with osteoporosis treated with romosozumab was not increased with regard to stroke, atrial fibrillation, heart failure, coronary artery disease, and cardiovascular death, although results were not completely conclusive [100] and a comparative trial is clearly needed.…”

Section: Safety Profile Of Romosozumabmentioning

confidence: 85%

“…Additionally, injection-site reactions were more likely with romosozumab treatment. In comparison to teriparatide, odds ratio for any adverse event was increased with romosozumab treatment [99]. A recent report described serious cardiovascular adverse events with romosozumab use in Japanese patients [103], although a sub-analysis from ARCH for East-Asian patients did not report an increased risk profile [80], and neither did the sub-analysis for Japanese patients from FRAME and its extension [79].…”

Section: Safety Profile Of Romosozumabmentioning

confidence: 93%

“…The rare but severe complication osteonecrosis of the jaw, which has been described with antiresorptive treatment, has not been observed in preclinical studies with sclerostin inhibition [102], while two cases were reported in FRAME, but may be explained by dental procedures [69]. The meta-analysis considering all doses of romosozumab (210, 140, and 70 mg), and including studies with all comparators (alendronate, teriparatide, and placebo) reported a slightly increased risk of osteoarthritis, albeit not statistically significant [99]. Additionally, injection-site reactions were more likely with romosozumab treatment.…”

Section: Safety Profile Of Romosozumabmentioning

confidence: 94%

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Osteoporosis Treatment with Anti-Sclerostin Antibodies—Mechanisms of Action and Clinical Application

Rauner

Taipaleenmäki

Tsourdi

et al. 2021

JCM

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Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risk of fragility fractures and significant long-term disability. Although both anti-resorptive treatments and osteoanabolic drugs, such as parathyroid hormone analogues, are effective in fracture prevention, limitations exist due to lack of compliance or contraindications to these drugs. Thus, there is a need for novel potent therapies, especially for patients at high fracture risk. Romosozumab is a monoclonal antibody against sclerostin with a dual mode of action. It enhances bone formation and simultaneously suppresses bone resorption, resulting in a large anabolic window. In this opinion-based narrative review, we highlight the role of sclerostin as a critical regulator of bone mass and present human diseases of sclerostin deficiency as well as preclinical models of genetically modified sclerostin expression, which led to the development of anti-sclerostin antibodies. We review clinical studies of romosozumab in terms of bone mass accrual and anti-fracture activity in the setting of postmenopausal and male osteoporosis, present sequential treatment regimens, and discuss its safety profile and possible limitations in its use. Moreover, an outlook comprising future translational applications of anti-sclerostin antibodies in diseases other than osteoporosis is given, highlighting the clinical significance and future scopes of Wnt signaling in these settings.

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“…13,16 A recent meta-analysis did not show a difference in CV events or death compared with placebo. 18…”

Section: Safetymentioning

confidence: 99%

Romosozumab: A Novel Injectable Sclerostin Inhibitor With Anabolic and Antiresorptive Effects for Osteoporosis

Nealy

Harris

2020

Ann Pharmacother

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Objective: To review the clinical pharmacology, efficacy, and safety of romosozumab, a humanized monoclonal antibody with a novel mechanism of action for monthly injection, and its place in the management of osteoporosis. Data Sources: PubMed, MEDLINE, and ClinicalTrials.gov searches (1966 to July 2020) were conducted using the keywords romosozumab and osteoporosis. Study Selection and Data Extraction: Published phase 2 and 3 clinical trials and 2 meta-analyses in patients with osteoporosis were included. Data Synthesis: Romosozumab increased bone mineral density (BMD) at the lumbar spine (12.1%-13.3%), femoral neck (2.2%-5.9%), and total hip (2.5%-6.9%) in patients with osteoporosis. After 12 months, romosozumab provided greater BMD gains at the lumbar spine and hip than teriparatide. However, teriparatide is likely to further increase BMD if continued for up to 24 months. In postmenopausal women at a high fracture risk, 1 year of romosozumab followed by 1 year of alendronate resulted in lower vertebral, nonvertebral, clinical, and hip fractures than alendronate alone for 2 years. Although absolute event rates were low, serious cardiovascular and cerebrovascular events were numerically higher in 2 clinical trials when compared with alendronate (2.5% vs 1.9%, respectively) and placebo (4.9% vs 2.5%, respectively). Relevance to Patient Care and Clinical Practice: This review discusses the place in therapy for romosozumab in osteoporosis management as a novel agent. Conclusions: Romosozumab offers an alternative for patients with a high risk of osteoporotic fractures. Clinicians should avoid romosozumab in patients with a history of myocardial infarction or stroke in the past 12 months.

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Efficacy and safety of Romosozumab in treatment for low bone mineral density: a systematic review and meta-analysis

Cited by 40 publications

References 38 publications

The Role of Adipokines and Bone Marrow Adipocytes in Breast Cancer Bone Metastasis

The Role of Adipokines and Bone Marrow Adipocytes in Breast Cancer Bone Metastasis

Osteoporosis Treatment with Anti-Sclerostin Antibodies—Mechanisms of Action and Clinical Application

Romosozumab: A Novel Injectable Sclerostin Inhibitor With Anabolic and Antiresorptive Effects for Osteoporosis

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