Denosumab is a specialty type of chemical called a monoclonal antibody that is designed to stop the bone cells responsible for removal of old bone.
If you understand the process of how bones break down and build, you will have a better grasp on why this medication may not be a leap forward in the fight against bone loss.
There are two types of cells, bone building cells and bone breaking cells. The purpose of the bone breaking cells is to remove old brittle bone that has been damaged due to everyday wear and tear.
The denosumab is an effective compound in the inhibition of these bone chomping cells, however, by inhibiting these cells you will retain old brittle bone while building new bone around the older bone. This, to me, is not an ideal approach…
Instead of inhibiting this process, I believe it’s more important to stimulate new bone growth. Aside from being a different type/class of pharmaceutical, denosumab is similar to Fosamax and Boniva in its mechanism of action.
Most of the research on denosumab has evaluated its impact on bone density rather than a more important endpoint of fracture risk. It’s possible to harden the bones while making them more prone to fracture. I believe that this occurs with long term Fosamax use and is likely to occur with denosumab. Only long term research will tell. Needless to say, I’m not excited about this medication, nor should you be.