Abstract
Romosozumab, which is approved for the treatment of osteoporosis, has a dual-action mechanism that promotes bone formation and inhibits bone resorption. However, its association with an increased risk of major adverse cardiovascular events, as highlighted in the ARCH I study, raises concerns. The underlying pathophysiological mechanisms, possibly involving changes in platelet dynamics, are yet to be fully elucidated. Herein, we present a case of a 60-year-old Korean woman diagnosed with immune thrombocytopenic purpura and new-onset osteoporosis, who was treated with romosozumab. Subsequent to the administration of romosozumab, there was a notable elevation in her platelet count. This observation warrants further investigation into the off-target effects of romosozumab, especially its impact on hematopoietic stem cell function and platelet dynamics. This case accentuates the imperative for more comprehensive research into the systemic effects of romosozumab, particularly its involvement in hematopoiesis and cardiovascular risk, to thoroughly understand its extensive implications for patient health.