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Rheum Dis Clin North Am. 2011 Aug;37(3):433-52, vi-vii. doi: 10.1016/j.rdc.2011.07.004.

The RANKL pathway and denosumab.

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Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.


Denosumab (Prolia) is a fully human monoclonal antibody directed against receptor activator of nuclear factor-κB ligand (RANKL), which interferes with the formation, activation, and survival of osteoclasts. It was approved by the Food and Drug Administration in June 2010 as a new treatment for postmenopausal osteoporosis in women who are at high risk for fracture. Given its mechanism of action, it is an antiresorptive therapy that is administered as a 60-mg subcutaneous injection every 6 months. It is the first biologic antiresorptive therapy for osteoporosis, and the first osteoporosis therapy to show efficacy and safety in patients with renal impairment.

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