Denosumab in afya

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relatively new treatment for osteoporosis. 
human monoclonal antibody that inhibits osteoclast formation, function and survival.  
subcutaneous injection, at a dose of 60mg, every 6 months.
larger dose of denosumab (120mg) may be given every 4 weeks for the prevention of skeletal-related events (i.e. pathological fractures) in adults with bone metastases from solid tumours. For example, you may have noticed some of your breast cancer patients have been prescribed denosumab.

''Where does it fit in the management of osteoporosis?''
Oral bisphosphonates first-line, -  oral alendronate 1st then risedronate or etidronate. 
Then ... depends on T score and other factors ...
Raloxifene, strontium ranelate, denosumab.

NICE published a technology appraisal looking at the role of denosumab in 2010. A link is provided.

''side-effects''
generally well tolerated. 
Dyspnoea and diarrhoea - 1 in 10 patients. 
less common -  hypocalcaemia and URTI.
rare -  atypical femoral fractures

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