Contraindications and Precautions for Romosozumab Therapy

Patient Selection and Contraindications

• In adults ≥40 years with moderate fracture risk, romosozumab is conditionally recommended against except in patients intolerant of other agents, due to risk of myocardial infarction, stroke, or death, as recommended by the American College of Rheumatology 1, 2
• Romosozumab is conditionally recommended against in solid organ transplants due to risk of myocardial infarction, stroke, or death, according to the American College of Rheumatology 3

Special Populations

• The use of romosozumab in males with CKD G4-G5D is considered off-label, as stated by the National Kidney Foundation 4, 5
• Women who may become pregnant should use effective birth control during treatment with romosozumab, as advised by the American College of Rheumatology 3

Treatment Duration and Sequencing

• After romosozumab treatment, sequential therapy with an anti-resorptive agent is recommended to maintain bone mineral density gains, as suggested by the American College of Physicians 6, 7