Cancel the Denosumab Holiday

Denosumab, a fully human IgG2 anti-RANK ligand antibody, quickly and substantially inhibits bone remodeling. As expected by the pharmacology of Denosumab, this inhibition of remodeling is completely reversible upon stopping treatment. In clinical trials, discontinuing therapy after 2 years results in a rapid rebound in bone turnover markers, raising concern about whether that high remodeling rate and consequent rapid bone loss that occurs has clinical relevance beyond a simple waning of the treatment benefit. Despite these concerns, many patients stop Denosumab therapy, sometimes upon the advice of their physicians, especially in preparation for invasive dental procedures….