Orthopedics · Metabolic Bone Diseases (Osteoporosis, Osteomalacia, Paget's)

A 70-year-old woman with osteoporosis is started on denosumab. The mechanism of action of denosumab is:

  • A Binding to and inhibiting RANK ligand, preventing osteoclast formation, function, and survival
  • B Incorporating into bone mineral and inducing osteoclast apoptosis via mevalonate pathway inhibition
  • C Activating osteoblast Wnt signaling pathway by neutralizing sclerostin
  • D Acting as a selective estrogen receptor modulator to reduce bone resorption
Correct answer: A. Binding to and inhibiting RANK ligand, preventing osteoclast formation, function, and survival

Explanation

Denosumab is a fully human monoclonal antibody against RANKL. By binding RANKL, it prevents RANKL from activating RANK on osteoclast precursors, thereby inhibiting osteoclast formation, function, and survival. Option B describes bisphosphonates. Option C describes romosozumab. Option D describes raloxifene.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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