Denosumab for Osteoporosis
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Denosumab is injected under the skin, usually every 6 months.
How It Works
Denosumab slows the formation and action of cells called osteoclasts. These are the cells that naturally break down bone. By slowing down the osteoclasts, denosumab allows bone to become more dense (thicker).
Why It Is Used
Denosumab is used for people who are at high risk for fractures related to decreased bone density.
How Well It Works
In one large study denosumab was given to women every 6 months for 3 years. These women were compared to women who received an injection of liquid that did not contain the medicine (placebo). The women who were given denosumab had much less risk of breaking a bone, such as a spine or hipbone, than the women who were given the placebo. footnote 1
Androgen-deprivation therapy is known to decrease bone density. A study of men having androgen-deprivation therapy for prostate cancer compared a group of men who also received denosumab to a group who did not. The men who received denosumab had increased bone density and fewer spine fractures. footnote 2
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor right away if you have:
- Signs of infection such as:
- Increased pain, swelling, warmth, or redness near the injection site.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.
Common side effects of this medicine include:
- Back pain.
- Other bone, joint, or muscle pain.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Problems with bone healing, particularly after dental surgery, have been found in some people who are taking denosumab. If you are taking denosumab and need dental surgery, talk with your doctor.
If you are taking denosumab, you should also take calcium and vitamin D supplements.
People who have very low calcium ( hypocalcemia ) should not take denosumab.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Cummings SR, et al. (2010). Denosumab for prevention of fracture in postmenopausal women with osteoporosis. New England Journal of Medicine, 361(8): 756–765.
- Smith MR, et al. (2009). Denosumab in men receiving androgen-deprivation therapy for prostate cancer. New England Journal of Medicine, 361(8): 745–755.
Current as of: November 14, 2014