Gestione clinica della terapia con Denosumab: in chi, quando e come interromperla

Denosumab (Dmab) is a potent antiresorptive agent approved for treatment of osteoporosis at a dose of 60 mg subcutaneously every 6 months. Differently from bisphosphonates, Dmab is not incorporated in the bone matrix and interruption or delay in its administration leads to a well-known rebound effect on bone turnover, resulting in a rapid loss of bone mineral density and an increased risk of multiple vertebral fractures. Given the clinical relevance of this phenomenon, the present review outlines current evidence and recent recommendations for the bone specialist regarding management of anti-osteoporotic therapy with Dmab, with a focus on the drug discontinuation.