Osteoporosis is a systemic bone disease characterized by decrease bone quality and quantity predisposing patients to an increased fracture risk. Different drug treatments are available. however, some patients have a very high fracture risk and have fractures despite treatment. For instance, patients with recent fractures, T-score <-3.0, patients using glucocorticoids and people older than 70 years, have a very high risk of osteoporotic fractures. In these cases, osteoanabolic drugs provide the strongest bone protection and must be used frontline. The discovery of mutations in the gene that encodes the sclerostin protein in Van Buchem disease and sclerosteosis allowed the development of the monoclonal antibody against this protein known as romosozumab. This osteoanabolic drug decreases fracture risk and its use is recommended in patients with a very high risk of fractures. The recommended duration for romosozumab is 12 months; however, additional cycles of treatment are possible. This drug provides an opportunity for most difficult cases and for patients with very high-risk. of fractures.
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