[Updates of denosumab, anti-RANKL antibody for osteoporosis]

Osteoporosis and osteoporosis-related fractures tend to increase year by year around the world including Japan. Denosumab, a fully human monoclonal antibody to receptor activator of NF-κB ligand (RANKL) , a cytokine member of the TNF family essential for osteoclast differentiation has recently been approved in Japan, Europe and the US for the treatment of postomenopausal osteoporosis as well as bone metastasis. In some large clinical trials, denosumab significantly decreased bone resorption, increased bone mineral density (BMD) , and reduced the risk of vertebral, nonvertebral and hip fractures in postmenopausal women. However, the mechanism of adverse events of denosumab, such as hypocalcemia and osteonecrosis of the jaws, has not been completely explained. Therefore, further knowledge should be accumulated by additional basic researches and clinical studies on denosumab.