Successful treatment of humeral shaft nonunion with romosozumab: A case report

Romosozumab is a humanized monoclonal anti-sclerostin antibody (Scl-Ab) that binds and inhibits sclerostin, thereby increasing bone formation and decreasing bone resorption. In 2019, the Japanese Ministry of Health, Labor and Welfare, and the FDA approved romosozumab for treating osteoporosis in men and in postmenopausal women at high risk of fracture. In the past decade, pharmacological systemic treatments using molecules in use for the treatment of the osteoporosis have been reported. Herein we reported the case of a 67-year-old woman with nonunion of humerus shaft fracture, in whom bone union could not be achieved after 11 months of conservative treatment; however, successful bone healing was achieved after once-a-month administration of romosozumab for 6 months. To our knowledge, this is the first case reporting the successful use of romosozumab for treating established nonunion. Romosozumab can aid in promoting bone healing of nonunion in patients not willing to undergo surgical intervention.