Romosozumab: from basic to clinical aspects.

The Wnt pathway has an important role in bone formation. Inactivation of sclerostin, an inhibitor of this pathway, has been associated with increased bone mass both in animal experiments and in human clinical trials. Romosozumab is a humanized monoclonal antibody targeting sclerostin. Preclinical studies showed that this antibody primarily increases bone formation resulting in increased bone mineral density. Initial studies carried out in humans are in line with data obtained in animals. If these results are confirmed in larger studies with fracture end-points, this monoclonal antibody with its anabolic action, will become a key drug in the treatment of osteoporosis.