CTSK and skin reaction: Taken together, this suggests that MIV-711 can produce consistent anti-resorptive effects at low circulating plasma levels indicating a sustained level of inhibition of osteoclast-derived cathepsin K. A compound producing a high level of efficacy at low circulating concentrations may be important when targeting cathepsin K. The cathepsin K inhibitor balicatib failed in clinical development due to rash and morphea-like skin reactions [43].