Prolia® (denosumab) mechanism of action
Prolia® (denosumab) is a monoclonal antibody that binds with high affinity and specificity to the RANK ligand (RANKL). RANKL is an cytokine that acts as a key mediator of bone resorption. It normally binds to its receptor, RANK, found on the surface of osteoclast precursors and osteoclasts. By preventing the RANKL-RANK interaction, osteoclast activity such as formation, function, and survival are inhibited thereby preventing the breakdown of both cortical bone and trabecular bone.
Prolia® (denosumab) is a medication for osteoporosis, and is the first antiresorptive therapy to target RANKL [25.3]. Earlier approved treatments for osteoporosis include bisphosphonates/biosphosphonate therapy, hormone replacement therapy (HRT), selective estrogen-receptor modulators; the parathyroid hormone analogue teriparatide that has an anabolic effect on bone tissue, and strontium ranelate that increases bone formation and decreases bone resorption.