After one year of treatment with denosumab, the incidence of fracture is lower in patients previously treated one year with romosozumab as compared with placebo. Cessation of denosumab injections is followed by a rebound of bone resorption, a decrease of bone mineral density and increased risk of multiple vertebral fractures. For safety reasons, odanacatib, an inhibitor of cathepsine K and consecutively of bone resorption will not be available. Abaloparatide, a PTHrp(Parathormon related protein) analog, decreases the incidence of vertebral and non vertebral fractures. In patients with diabetes, the incidence of fractures is increased mainly due to alterations quality of bone.
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