Seems to be virtually impossible to safely discontinue denosumab after starting it. Maybe the solution is to not start it in the first place? Certainly it should not be prescribed to younger patients who may therefore spend decades on this medication. As denosumab affects the immune system I'd think that alone would be a good reason to avoid it. Interesting discussion on this website:
melioguide.com/osteoporosis...
The comments at the end are also very interesting.