Antibody Treatment and Osteoporosis: Clinical Perspective

Osteoporosis is the most worldwide diffuse skeletal disease requiring new therapeutic strategies for its cure. The discovery of the pro-osteoclastogenic receptor activator of nuclear factor kappa-B ligand (RANKL) and anti-osteoblastogenic sclerostin’s role is strongly changing the therapeutic approach. In this chapter, we overview the literature and data on the use of denosumab and romosozumab, antibodies against RANKL and sclerostin respectively, for osteoporosis management. Clinical trials show that denosumab long-term treatment determines a continuous augment of the bone mineral density (BMD) with few adverse effects. Most recent trials on romosozumab treatment reports bone formation increase and BMD improvement, although there are controversial reports on its adverse effects, with particular regard to cardiovascular events