# Romosuzumab used to treat a 29-year-old patient with anorexia nervosa related osteoporosis – A case report

## TL;DR

A 29-year-old anorexia nervosa patient showed improved bone density after 12 months of romosuzumab treatment, suggesting it could be a new treatment option.

## Contribution

This is the first reported case of romosuzumab successfully treating anorexia-related osteoporosis in a premenopausal patient.

## Key findings

- Romosuzumab significantly increased bone mineral density in a young anorexia nervosa patient.
- Treatment with romosuzumab showed better clinical efficacy than bisphosphonates and teriparatide in key bone regions.
- Romosuzumab was well tolerated over 12 months with no serious side effects.

## Abstract

Osteoporosis and decreased bone density is a frequent complication of anorexia nervosa (AN). As of yet, there have been no studies of accomplished treatment of AN-related osteoporosis with romosuzumab, a monoclonal antibody to sclerostin. We report the first case of a premenopausal, 29-year old patient in Switzerland with decreased bone density and osteoporotic fractures due to anorexia nervosa, who completed the treatment with romosuzumab. There was a significant increase in bone mineral density (BMD) after 12 months of therapy. No serious side effects were reported. To date, only bisphosphonates, denosumab and teriparatide have been evaluated in treatment of AN-related osteoporosis in adolescents and premenopausal individuals respectively. Our report demonstrates that romosuzumab might be an alternative treatment option in patients with anorexia nervosa who are at high risk for osteoporotic fractures. To assess the efficacy and safety of romosuzumab in individuals with AN further studies are needed.

•Romosuzumab demonstrates a significant osteoanabolic effect and increases bone mineral density in young anorexia nervosa patients significantly•Treatment with romosozumab showed superior clinical efficacy to bisphosphonates and teriparatide in terms of BMD of the lumbar spine, femoral neck and total hip•Romosuzumab treatment for 12 months was well tolerated

Romosuzumab demonstrates a significant osteoanabolic effect and increases bone mineral density in young anorexia nervosa patients significantly

Treatment with romosozumab showed superior clinical efficacy to bisphosphonates and teriparatide in terms of BMD of the lumbar spine, femoral neck and total hip

Romosuzumab treatment for 12 months was well tolerated