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[New osteoformative agents for osteoporosis]
1Fondation Rothschild, service de médecine interne et rhumatologie, Fondation Rothschild, 25, rue Manin, 75940 Paris, France. dchaouat@fo-rothschild.fr
Purpose:
Antiresorptive therapy are usual treatment of osteoporosis, but they prevent no more than 40 or 60% of osteoporotic fracture. Thus, there is a need for osteoformative agents that can further augment bone mass and reduce risk fracture more substantially. CURRENT KNOWLEDGER AND KEYPOINTS: Daily injections of 1-34 aminoterminal fragment of PTH increase bone formation and bone mass. A randomized study recently demonstrated that PTH 1-34 decrease the risk of vertebral and non vertebral fracture, and the place of this treatment in the strategy of osteoporosis treatment is to demonstrate. Oral administration of strontium salt at low dosage level stimulate bone formation and decrease bone resorption. Preliminary data needs to be confirmed by a multicenter antifracture study. Retrospective results with statins in three international studies have not be confirmed by the only randomized clinical trial. Use of low dose intermittent fluoride therapy are still recommended by some authors. FUTURES PROSPECTS AND PROJECTS: Effects of insuline like growth factor I and other growing factor on bone turnover have to be confirmed in human, and pharmacological and tolerance problems have to be solved.