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Sclerostin is an osteocyte-secreted glycoprotein that inhibits bone formation. By binding to sclerostin, the monoclonal antibody romosozumab stimulates bone formation. In an industry-supported, phase II placebo-controlled study, menopausal women with low bone mineral density (BMD) were randomized to receive subcutaneous romosozumab (1 of 3 possible doses monthly or every 3 months), oral alendronate (70 mg weekly), or subcutaneous teriparatide (20 µg daily) for 12 months.
Among 383 women (86% white; mean age, 67; mean baseline T-scores, −2.29 and −1.53 at lumbar spine and total hip, respectively), those who received romosozumab (regardless of dose or frequency) experienced significant increases in BMD compared with placebo. The largest gains …