Denosumab

Advantages

+ Highest reduction in hip fracture risk (hip fracture is the leading mechanism for osteoporosis-related death)

+ Administration once every 6 months convenient

Disadvantages

– Stopping denosumab leads to large and fast decreases in bone mineral density!

– A few rare cases of osteonecrosis of the jaw and atypical femoral fractures

– Only useful if resorption and formation pre-treatment are high as it reduces resorption 90% and formation 80% which is undesirable if these are already low.