ostmenopausal osteoporosis, primary hyperparathyroidism, denosumab, cytokine system rank/rankl/opg, Physiology, QP1-981, Biochemistry, QD415-436

He main issue in osteoporosis management is the duration of treatment with different drugs particularly in cases of severe osteoporosis with high fracture risks and indications of switching from one to other agents. Denosumab is a new class of osteoporosis treatment called a human monoclonal antibody that prevents RANKL-RANK interaction and thereby inhibits osteoclast formation, demonstrates significant efficacy for vertebral, nonvertebral and hip fracture risk reduction. This case demonstrates multifactorial reasons for osteoporosis development (postmenopausal osteoporosis, primary hyperparathyroidism), as well as the long-term applying of different osteoporosis drugs with various actions mechanisms and different effectiveness.