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Arterioscler Thromb Vasc Biol. 2019 Jul;39(7):1343-1350. doi: 10.1161/ATVBAHA.119.312371. Epub 2019 May 23.

Cardiovascular Outcomes of Romosozumab and Protective Role of Alendronate.

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From the Division of Endocrinology and Molecular Medicine, Department of Medicine, University of Kentucky, Lexington (K.A.).
Departments of Medicine (Cardiology) and Cell Biology, and the Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine, New York (A.W.).


Osteoporosis and cardiovascular diseases are major public health issues. Bone and cardiovascular remodeling share multiple biological markers and pathways. Medical intervention, such as using romosozumab, an antisclerostin antibody, improves the clinical outcome of osteoporosis. However, blocking sclerostin leads to Wnt (wingless/integrated) activation and participation in the cardiovascular remodeling process, which could potentially lead to adverse events. Based on the opposing roles of bisphosphonates and the Wnt pathway on endothelial dysfunction, lipid accumulation and calcification of the vessel walls, the combination of romosozumab and bisphosphonates could be a new therapeutic approach to reducing the risks of adverse cardiovascular events in romosozumab receivers. Visual Overview- An online visual overview is available for this article.


Wnt signaling pathway; alendronate; cardiovascular diseases; lipid; osteoporosis; public health


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