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Denosumab is a monoclonal antibody which binds to the receptor activator of nuclear factor- κB ligand (RANKL), reducing osteoclastic activity and bone turnover. The Fracture REduction Evaulation of Denosumab in Osteoporosis every 6 Months (FREEDOM) trial showed a significant reduction in relative risk of fractures with increased bone mineral density (BMD) with denosumab. A trial of DenosumAb versus placebo in Males with Osteoporosis (ADAMO) demonstrated the similar effect of denosumab for improving BMD and reducing bone turnover in men. However, concerns were identified regarding increased risk of fractures with denosumab cessation. Until further evidence is available, bisphosphonate treatment is recommended to attenuate this risk with denosumab discontinuation.
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Shyh Poh Teo (2020) studied this question.
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