Abstract
Osteoporosis is a prominent cause of morbidity in patients with thalassaemia major (TM) with a complex pathophysiology. Patients with TM and osteoporosis have elevated markers of bone resorption. This increased osteoclast activity seems to be at least partially due to an imbalance in the receptor–activator of nuclear factor-kappa B ligand (RANKL)/osteoprotegerin (OPG) system, which is of great importance for the regulation of osteoclast differentiation and function. Denosumab is a fully human monoclonal antibody that binds to RANKL and thereby inhibits the activation of osteoclasts by RANKL. By blocking RANKL, denosumab inhibits osteoclast formation, function and survival, thereby decreasing bone resorption and increasing bone mass in postmenopausal women and patients with thalassaemia-induced osteoporosis.
Highlights
Osteoporosis is a prominent cause of morbidity in patients with by unmodified OPG levels, with the consequent increase of thalassaemia major (TM) with a complex pathophysiology
The increased bone resorption observed in TM patients with an imbalance in the receptor–activator of nuclear factor-kappa B lig- osteoporosis has led to the use of bisphosphonates (inhibitors of and (RANKL)/osteoprotegerin (OPG) system, which is of great osteoclast function) in the management of osteoporosis in this importance for the regulation of osteoclast differentiation and func- cohort of patients [3, 5, 6]
A novel monoclonal antibody which targets RANKLis available for osteoporosis patients and it is of great importance to know its efficacy in thalassaemia patients with osteoporosis
Summary
The increased bone resorption observed in TM patients with an imbalance in the receptor–activator of nuclear factor-kappa B lig- osteoporosis has led to the use of bisphosphonates (inhibitors of and (RANKL)/osteoprotegerin (OPG) system, which is of great osteoclast function) in the management of osteoporosis in this importance for the regulation of osteoclast differentiation and func- cohort of patients [3, 5, 6]. We and others have previously shown that RANKL, the most potent osteoclast activator, is elevat-
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