Sandoz announced the commercial availability of WYOST® (denosumab-bbdz) and Jubbonti® (denosumab-bbdz) in the United States, marking the introduction of the first and only FDA-approved interchangeable denosumab biosimilars. The launch addresses critical treatment needs for patients with osteoporosis and cancer-related skeletal complications, potentially improving access to these vital therapies through more affordable options.
Addressing Significant Patient Populations
The biosimilars target substantial patient populations facing serious bone-related conditions. Over 10 million US adults aged 50 and older live with osteoporosis, with an additional 43 million at risk due to low bone mass. The condition's impact is severe, with half of all women and a quarter of all men over 50 expected to break a bone due to osteoporosis.
For cancer patients, approximately 330,000 people in the US are living with bone metastases, which occur most commonly in patients with breast, prostate, lung, kidney and thyroid cancers. These metastases weaken bone structure and often cause significant skeletal-related events including pain and fractures.
Therapeutic Mechanisms and Indications
Both WYOST® and Jubbonti® are human monoclonal antibodies designed to bind to the RANKL protein, an activator of osteoclasts responsible for breaking down bone tissue. The biosimilars maintain identical dosage forms, routes of administration, dosing regimens and presentations as their respective reference medicines.
WYOST® (120 mg/1.7 mL injection) is indicated to prevent skeletal-related events in patients with multiple myeloma and bone metastases from solid tumors. Additional indications include treating adults and skeletally mature adolescents with giant cell tumor of bone that is unresectable or where surgical resection would result in severe morbidity, and treating hypercalcemia of malignancy refractory to bisphosphonate therapy.
Jubbonti® (60 mg/1 mL injection) is indicated for treating postmenopausal women with osteoporosis at high risk for fracture, increasing bone mass in men with osteoporosis at high risk for fracture, and treating glucocorticoid-induced osteoporosis. The drug also increases bone mass in men receiving androgen deprivation therapy for nonmetastatic prostate cancer and women receiving adjuvant aromatase inhibitor therapy for breast cancer.
Safety Considerations and Monitoring Requirements
Both biosimilars carry important safety warnings requiring careful patient monitoring. WYOST® requires correction of hypocalcemia prior to initiation, with ongoing monitoring of calcium levels, especially during the first weeks of therapy. Patients must receive adequate calcium and vitamin D supplementation throughout treatment.
Jubbonti® carries a boxed warning for severe hypocalcemia in patients with advanced kidney disease, including those with chronic kidney disease-mineral bone disorder. Healthcare providers must evaluate for the presence of this condition before initiating treatment, and therapy should be supervised by providers with expertise in managing these complications.
Both products require monitoring for osteonecrosis of the jaw, atypical femoral fractures, and hypersensitivity reactions including anaphylaxis. Patients should avoid invasive dental procedures during treatment and be evaluated for thigh or groin pain that could indicate femoral fractures.
Market Impact and Company Strategy
The launch builds on Sandoz's established leadership in biosimilars, dating back to the introduction of the first biosimilar in the US in 2015. Keren Haruvi, President Sandoz North America, emphasized that "denosumab is a vital medicine for conditions such as osteoporosis and cancer-related skeletal events. Providing an additional high-quality, cost-effective treatment option helps improve access and affordability for US patients."
Claire Gill, Chief Executive Officer of the Bone Health and Osteoporosis Foundation, noted that "bone loss and cancer-related skeletal complications can have a profound impact on patients' lives, but access to effective treatments has often been impacted by cost. With the introduction of new biosimilar options, patients now have access to more treatments they need and deserve."
Patient Support and Access
Sandoz is providing comprehensive support resources for patients prescribed WYOST® and Jubbonti®, including reimbursement and financial support programs. Both products will launch with established Q codes to facilitate insurance coverage and pharmacy dispensing.
The interchangeable designation allows pharmacists to substitute these biosimilars for the reference products without requiring a new prescription from the healthcare provider, potentially streamlining access for patients already receiving denosumab therapy.
