Denosumab in the first line treatment of osteoporosis

Abstract

In Czechia, since April 1st 2020 denosumab has been approved as the first line anti-osteoporotic treatment in patients older than 70 years. While choosing optimal anti-osteoporotic treatment in the first line (denosumab or bisphosphonates) it is essential to consider specific contraindications and tolerance (with great impact on adherence and thus the fracture and even mortality risk).

All these factors are discussed, as well as the comparison of efficacy (BMD increase, reduction of fracture risk, risk of serious adverse events), adherence and persistence to treatment are provided. At the end, current expert recommendation is commented and possible densitometry therapeutic goals are suggested.