Sclerostin inhibitors
Antibodies that remove the brake sclerostin puts on bone-building cells. Bone formation rises quickly and fractures fall.
What they are
Monoclonal antibodies against sclerostin, a protein made by osteocytes that inhibits bone formation. They treat severe osteoporosis in postmenopausal women at high fracture risk, for a fixed course, followed by an antiresorptive drug. Romosozumab is the member in use.
Mechanism of action
Sclerostin blocks Wnt signalling in osteoblasts by binding the LRP5/6 co-receptors. Neutralising sclerostin releases Wnt signalling, so osteoblasts form more bone; at the same time bone resorption falls. The result is a rapid rise in bone mineral density (a dual effect, unlike PTH analogues, which also increase resorption).
Target: Sclerostin (SOST), an osteocyte protein that inhibits Wnt signalling
Drugs in this class
Test yourself
Think of the answer, then tap the question to see it.
Which signalling pathway does sclerostin inhibit?
The Wnt pathway in osteoblasts, by binding the LRP5/6 co-receptors; blocking sclerostin restores bone formation.
What cardiovascular warning applies to romosozumab?
It may raise the risk of heart attack, stroke and cardiovascular death, so it is avoided after a recent heart attack or stroke.
What usually follows a course of a sclerostin inhibitor?
An antiresorptive drug (such as denosumab or a bisphosphonate) to maintain the bone density gained.
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Romosozumab-aqqg Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026).
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Representative model, for educational purposes only.