Rheumatoid arthritis (RA) is a chronic inflammatory diseases marked by focal pathologic bone resorption. This is due to the excessive activity of osteoclasts (OC). The receptor activator of nuclear factor kappa B ligand (RANKL) is significant for the proliferation, differentiation, and survival of OC. Denosumab (DMab) is a humanized monoclonal antibody. It binds to RANKL with high affinity and blocks its subsequent alliance with its receptor RANK on the surface of OC precursors.

The authors of this study review the molecular and cellular mechanisms underlying therapeutic applications of DMab, supplement recent highlights on pharmacology, efficacy and safety of DMab, and discuss the potential of DMab as a novel therapeutic option for the rheumatoid arthritis treatment.

Thus, the clinical results revealed that DMab is efficient both in systemic and articular bone loss in RA with finite side effects. The RA patients on corticosteroids and bisphosphonates displayed diminished bone erosion activity. The blend of DMab with an anti-TNF agent was not connected with increased infection rates.

All in all, the data obtained from this study point-out that DMab, in combination with methotrexate and possibly other conventional synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs), is an effective, safe and cost-effective choice for the treatment of RA.