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A bispecific antibody targeting both sclerostin (SOST) and Dickkopf-1 (DKK1), which are key negative regulators of the Wnt signaling pathway in bone metabolism. By simultaneously neutralizing both sclerostin and DKK1, the antibody promotes bone formation (osteoblastogenesis) and suppresses bone resorption (osteoclastogenesis), leading to rapid and robust gains in bone mineral density (BMD) and bone strength. This dual-targeting approach is designed to prevent the compensatory increases in DKK1 that typically limit the efficacy of sclerostin-only inhibitors. Clinical-stage candidates utilizing this mechanism, such as Angitia Biopharmaceuticals' AGA2118 and AGA2115, are being evaluated for the treatment of postmenopausal osteoporosis, osteogenesis imperfecta, and other bone-related disorders like renal osteodystrophy in chronic kidney disease (CKD).
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