Illustration of bones strengthened by denosumab.

Brittle Bones Breakthrough: Can Denosumab Offer Hope for Osteogenesis Imperfecta?

Avery Sinclair in Health & Wellness December 2025 • 5 min read.

"A case series explores the potential of denosumab therapy to improve bone density and reduce fractures in patients with osteogenesis imperfecta (OI), offering a new option for managing this challenging condition."

Osteogenesis imperfecta (OI), often referred to as brittle bone disease, is a genetic disorder affecting the connective tissues, primarily characterized by fragile bones that are prone to frequent fractures. This condition arises from defects in type I collagen, a crucial protein that provides strength and structure to bones. While there are existing treatments, there's a constant search for better solutions, especially for OI patients who also have osteoporosis.

Bisphosphonates are a common treatment, but they aren't perfect and don't work for everyone. So, scientists are looking into new options, including a drug called denosumab. Denosumab is already used to treat osteoporosis in the general population, but it's not as well-known for OI. Some early studies have been promising, suggesting it could help improve bone density and reduce fractures in children and adults with OI. However, more information is needed to understand how well it works and if it's safe, especially for kids.

This article breaks down a recent study that looked at how denosumab affected eight people with OI and osteoporosis. The study tracked their bone mineral density (BMD), fracture rates, and any side effects they experienced. By understanding the results of this study, we can gain insights into whether denosumab could be a valuable treatment option for people with OI-related osteoporosis.

Denosumab: A Promising Solution for Stronger Bones?

Illustration of bones strengthened by denosumab.

In a recent case series, researchers closely monitored eight individuals with OI who were also battling osteoporosis. These patients, ranging in age from 3 to 51 years, received denosumab injections every six months. The goal was to see if the drug could improve their bone health and reduce the risk of fractures. Before starting denosumab, many of these patients had a history of multiple fractures, highlighting the severity of their condition.

The study tracked several key indicators, including:

Bone Mineral Density (BMD): Measurements were taken of the lumbar spine (L-BMD) and both hips (H-BMD) to assess bone strength.
Bone Turnover Markers: Blood and urine tests were conducted to measure bone-specific alkaline phosphatase (BAP), urinary N-terminal telopeptide of type I collagen (NTX), and tartrate-resistant acid phosphatase 5b (TRACP-5b). These markers provide insights into bone formation and resorption.
Fracture Incidence: Researchers carefully monitored whether any new fractures occurred during the study period.

The results of the study were encouraging. In seven out of the eight patients, both L-BMD and H-BMD increased during denosumab therapy, suggesting that the drug was effective in improving bone density. Additionally, bone turnover markers were inhibited in most cases, indicating a reduction in bone breakdown. Importantly, apart from one fracture in a young girl, no severe side effects, such as hypocalcemia (low calcium levels), were observed during the study. While further research is needed, these findings suggest that denosumab could be a safe and effective treatment option for OI patients with osteoporosis.

The Future of OI Treatment: A Step Forward

This case series offers a promising glimpse into the potential of denosumab therapy for individuals with OI and osteoporosis. The findings suggest that denosumab can effectively improve bone density and reduce fracture risk in this population. Given the challenges associated with current treatments, denosumab could provide a valuable alternative for managing OI-related osteoporosis.

While the results are encouraging, it's important to acknowledge the limitations of this study. The small sample size and retrospective design mean that further research is needed to confirm these findings and fully understand the long-term effects of denosumab in OI patients. Future studies should include larger, randomized controlled trials to provide more definitive evidence.

Denosumab shows promise as a new way to tackle brittle bones and osteoporosis in people with OI. More research will help us fully understand how best to use this treatment. The initial results show promise and provides motivation to continue the work.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3390/jcm7120479, Alternate LINK

Title: Efficacy And Safety Of Denosumab Therapy For Osteogenesis Imperfecta Patients With Osteoporosis—Case Series

Subject: General Medicine

Journal: Journal of Clinical Medicine

Publisher: MDPI AG

Authors: Tsukasa Kobayashi, Yukio Nakamura, Takako Suzuki, Tomomi Yamaguchi, Ryojun Takeda, Masaki Takagi, Tomonobu Hasegawa, Tomoki Kosho, Hiroyuki Kato

Published: 2018-11-24

Everything You Need To Know

What is Osteogenesis Imperfecta and why is it relevant?

Osteogenesis imperfecta (OI), commonly known as brittle bone disease, is a genetic disorder. This condition arises from defects in type I collagen, a crucial protein that provides strength and structure to bones. People with OI experience fragile bones that are prone to frequent fractures, impacting their quality of life significantly. The search for improved treatments for OI is ongoing, with a focus on interventions that can improve bone density and reduce fracture risk.

What is denosumab and why is it considered important in this context?

Denosumab is an anti-resorption drug being explored as a potential treatment for Osteogenesis Imperfecta (OI) and osteoporosis. It functions by inhibiting bone breakdown, potentially leading to increased bone density and reduced fracture risk. The significance of denosumab lies in its potential to offer a new treatment option for those with OI, particularly those also affected by osteoporosis. This is important because current treatments like bisphosphonates are not always effective for every patient. This drug offers a potential alternative.

What did the study in the article involve?

The study followed eight individuals with Osteogenesis Imperfecta (OI) and osteoporosis, monitoring their bone mineral density (BMD), fracture rates, and bone turnover markers. Measurements of the lumbar spine (L-BMD) and both hips (H-BMD) were taken to assess bone strength. Bone turnover markers, including bone-specific alkaline phosphatase (BAP), urinary N-terminal telopeptide of type I collagen (NTX), and tartrate-resistant acid phosphatase 5b (TRACP-5b), provided insights into bone formation and resorption. Fracture incidence was also carefully monitored. The data collected gave researchers important insights into denosumab's effects and its potential as a treatment option for individuals with OI-related osteoporosis.

What were the key findings of this study?

The key findings of the case series show that, in seven out of eight patients with Osteogenesis Imperfecta (OI), both lumbar spine (L-BMD) and hip (H-BMD) increased during denosumab therapy, indicating improved bone density. Additionally, bone turnover markers were inhibited in most cases, suggesting a reduction in bone breakdown. Apart from one fracture in a young girl, no severe side effects, such as hypocalcemia, were observed. These results suggest that denosumab may be a safe and effective treatment option for OI patients also experiencing osteoporosis, offering a potential alternative to existing treatments.

What are the implications of this study's findings?

The implications of these findings are promising. Denosumab could provide a valuable alternative for managing Osteogenesis Imperfecta (OI)-related osteoporosis. The case series suggests that the drug can improve bone density and reduce fracture risk. However, it is important to note that this study included a small number of participants. Further research is needed to confirm these findings and to evaluate the long-term safety and efficacy of denosumab in a larger and more diverse population of OI patients. The successful use of denosumab has the potential to improve quality of life for people with OI.