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Cardiovascular Outcomes of Romosozumab and Protective Role of Alendronate

Kamyar Asadipooya1, Ada Weinstock2

  • 1From the Division of Endocrinology and Molecular Medicine, Department of Medicine, University of Kentucky, Lexington (K.A.).

Arteriosclerosis, Thrombosis, and Vascular Biology
|June 27, 2019
PubMed

Insights

Romosozumab treats osteoporosis by activating the Wnt pathway, which may increase cardiovascular risks. Combining romosozumab with bisphosphonates may reduce these adverse cardiovascular events.

Area of Science:

  • Bone biology and cardiovascular health
  • Endocrinology and metabolic diseases

Background:

  • Osteoporosis and cardiovascular diseases are significant public health concerns.
  • Bone and cardiovascular remodeling share common biological pathways.
  • Romosozumab, an antisclerostin antibody, improves osteoporosis outcomes but may pose cardiovascular risks due to Wnt pathway activation.

Purpose of the Study:

  • To explore the potential cardiovascular risks associated with romosozumab treatment.
  • To investigate the combined therapeutic potential of romosozumab and bisphosphonates for managing osteoporosis and mitigating cardiovascular risks.

Main Methods:

  • Review of biological markers and pathways involved in bone and cardiovascular remodeling.
  • Analysis of the Wnt pathway's role in cardiovascular processes.
  • Evaluation of the opposing effects of bisphosphonates and Wnt activation on vascular health.

Main Results:

  • Sclerostin inhibition by romosozumab activates the Wnt pathway, potentially impacting cardiovascular remodeling.
  • Bisphosphonates and Wnt pathway activation have opposing effects on endothelial dysfunction, lipid accumulation, and vascular calcification.

Conclusions:

  • The combination of romosozumab and bisphosphonates presents a novel therapeutic strategy.
  • This combination may reduce the risk of adverse cardiovascular events in patients receiving romosozumab for osteoporosis.

Keywords:
Wnt signaling pathwayalendronatecardiovascular diseaseslipidosteoporosispublic health

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