Papel del Romosozumab en la práctica clínica a la luz de la evidencia

La osteoporosis es una enfermedad sistémica ósea caracterizada por un deterioro en la calidad y cantidad de hueso que determina un riesgo de fracturas. Existen múltiples opciones de tratamiento para disminuir este desenlace. Sin embargo, algunos pacientes las presentan a pesar del tratamiento y otros, tienen un riesgo muy alto de sufrirlas. En particular, los pacientes con fractura reciente, T-score <-3.0, fracturas durante el uso de glucocorticoides y pacientes mayores de 70 años tienen un mayor riesgo comparado con otros pacientes. En estos casos, las terapias osteoanabólicas brindan una mejor protección ósea y deben considerarse la primera línea de tratamiento. El descubrimiento del gen alterado de la esclerostina en la génesis de la enfermedad de Van Buchem y la esclerosteosis, permitió el desarrollo de un anticuerpo monoclonal contra esta proteína, el romosozumab. Este medicamento es un anabólico óseo que disminuye el riesgo de fracturas y es de uso recomendado en pacientes con osteoporosis de muy alto riesgo. Su uso es por 12 meses, aunque existe evidencia de re-tratamiento. Este medicamento brinda una oportunidad para los pacientes más difíciles de tratar o con osteoporosis de muy alto riesgo.

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osteoporosis
romosozumab
esclerostina
denosumab
teriparatida
fracturas