Romosozumab treatment in postmenopausal women with osteoporosis: a meta-analysis of randomized controlled trials

Liu, Y; Cao, Yan; Zhang, S; Zhang, W; Zhang, B; Tang, Qing; Li, Z; Wu, Junyan

doi:10.1080/13697137.2018.1433655

Cited by 46 publications

(22 citation statements)

References 25 publications

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“…A meta‐analysis of six trials showed that romosozumab significantly reduces the risk of new vertebral fracture, non‐vertebral fracture and hip fracture compared with other treatments, and improves BMD. The dose of 210 mg monthly showed the largest gains in BMD.…”

Section: Dual Actions Drug: Romosozumabmentioning

confidence: 99%

Osteoanabolic and dual action drugs

Tabacco

Bilezikian

2019

Brit J Clinical Pharma

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Teriparatide (TPTD) and Abaloparatide (ABL) are the only osteoanabolic drugs available, at this time, for treatment of osteoporosis. TPTD is a 34-amino acid fragment that is identical in its primary sequence to the 34 amino acids of full-length human parathyroid hormone [hPTH(1-84)]. ABL is identical to parathyroid hormone related peptide (PTHrP) through the first 22 residues with significantly different amino acids inserted thereafter, between residues 22 and 34. The osteoanabolic actions of PTH are due directly to its effects on cells of the osteoblast lineage and indirectly by stimulating IGF-I synthesis and suppressing sclerostin and associated enhancement of Wnt signaling. Both TPTD and ABL are ligands that bind to and activate the PTH receptor type 1 (PTHR1) receptor but they appear to do so differently: ABL favors the transient, more anabolic configuration of the receptor. Both TPTD and ABL reduce the risk of vertebral fractures and non-vertebral fractures. Both drugs are administered for a maximum of 24 months, and should be followed by an anti-resorptive agent to maintain gains in BMD. Romosozumab, a monoclonal antibody that binds to and inhibits sclerostin, appears to have dual actions by stimulating bone formation and reducing bone resorption. In the pivotal clinical trial, romosozumab, administered as a 210 mg monthly subcutaneous dose, significantly reduced new vertebral fractures and in a subsequent study reduced both vertebral and non-vertebral fractures.

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Section: Dual Actions Drug: Romosozumabmentioning

confidence: 99%

Osteoanabolic and dual action drugs

Tabacco

Bilezikian

2019

Brit J Clinical Pharma

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“…Improving the predictive value of risk calculation tools for osteoporosis, developing similar tools for sarcopenia, and integrating sarcopenia within current calculation tools remain future challenges. A seemingly promising treatment targeting sclerostin (romosozumab) demonstrated a significantly lower rate of fracture in osteoporotic women, mostly in vertebral fractures . However, approval was delayed due to concern over serious cardiovascular events .…”

Section: Emerging Science and Future Questionsmentioning

confidence: 99%

“…A seemingly promising treatment targeting sclerostin (romosozumab) demonstrated a significantly lower rate of fracture in osteoporotic women, mostly in vertebral fractures. 74 However, approval was delayed due to concern over serious cardiovascular events. 75 In addition, the duration and sequence of antiresorptive and boneforming therapy is an ongoing source of debate.…”

Section: Emerging Science and Future Questionsmentioning

confidence: 99%

Osteoporosis in Older Persons: Old and New Players

Zanker

Duque

2018

J American Geriatrics Society

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Osteoporosis is the most common bone disease in humans. Older persons are at higher risk of osteoporotic fractures that also result in poor quality of life, disability, loss of independence, institutionalization, and higher mortality. Osteoporosis shares a distinct pathophysiologic relationship with sarcopenia, an age‐related disease comprising declines in muscle mass, strength, or function. The combination of these two diseases is known as osteosarcopenia. Understanding the pathophysiology of osteosarcopenia, in addition to its diagnostic and therapeutic approaches, is key in providing older adults with the best falls and fractures prevention strategies. This review provides updated information on new discoveries on the combined pathophysiology of osteoporosis and sarcopenia that have led to the development of novel therapeutic approaches. New recommendations for the use of risk calculators and densitometry are also presented in this review as well as evidence on current and upcoming pharmacologic treatments to prevent falls and fractures in older persons. J Am Geriatr Soc 67:831–840, 2019.

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“…Thus, the inhibition of sclerostin can induce the activation of osteoblasts and promote bone formation (Figure 1 and Figure 2). For therapeutic use in humans, the anti-sclerostin antibody (romosozumab) has been developed for the treatment of osteoporosis, which decreases endogenous levels of sclerostin, allowing for osteogenesis through an improvement in osteoblast survival [117,118,119]. Several authors have reported on the anabolic effect of anti-sclerostin antibody in enhancing the bone formation and fracture healing in animal models [120,121,122,123,124].…”

Section: Anti-sclerostin Antibodymentioning

confidence: 99%

The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease

Makino¹,

Tsukazaki²,

Ukon³

et al. 2018

IJMS

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In this era of aging societies, the number of elderly individuals who undergo spinal arthrodesis for various degenerative diseases is increasing. Poor bone quality and osteogenic ability in older patients, due to osteoporosis, often interfere with achieving bone fusion after spinal arthrodesis. Enhancement of bone fusion requires shifting bone homeostasis toward increased bone formation and reduced resorption. Several biological enhancement strategies of bone formation have been conducted in animal models of spinal arthrodesis and human clinical trials. Pharmacological agents for osteoporosis have also been shown to be effective in enhancing bone fusion. Cytokines, which activate bone formation, such as bone morphogenetic proteins, have already been clinically used to enhance bone fusion for spinal arthrodesis. Recently, stem cells have attracted considerable attention as a cell source of osteoblasts, promising effects in enhancing bone fusion. Drug delivery systems will also need to be further developed to assure the safe delivery of bone-enhancing agents to the site of spinal arthrodesis. Our aim in this review is to appraise the current state of knowledge and evidence regarding bone enhancement strategies for spinal fusion for degenerative spinal disorders, and to identify future directions for biological bone enhancement strategies, including pharmacological, cell and gene therapy approaches.

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Romosozumab treatment in postmenopausal women with osteoporosis: a meta-analysis of randomized controlled trials

Abstract: In postmenopausal women with osteoporosis who were at high risk for fracture, romosozumab treatment resulted in a significantly lower risk of fracture. Romosozumab 210 mg monthly showed the largest gains in BMD, and was generally well tolerated.

Cited by 46 publications

References 25 publications

Osteoanabolic and dual action drugs

Osteoanabolic and dual action drugs

Osteoporosis in Older Persons: Old and New Players

The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease

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