New therapies for osteoporosis: zoledronic acid, bazedoxifene, and denosumab

Intravenous (IV) zoledronic acid, a new once-yearly bisphosphonate therapy, is approved by the US Food and Drug Administration for treatment of postmenopausal osteoporosis, glucocorticoid-induced osteoporosis, and osteoporosis in men. IV zoledronic acid significantly reduced the risk of vertebral, nonvertebral, and hip fractures in postmenopausal women and decreased risk of clinical fracture and clinical vertebral fracture in men and women with hip fracture. Two promising new therapies are in late clinical development. Denosumab is a monoclonal receptor activator of nuclear factor- kappaB ligand (RANKL) antibody given by subcutaneous injection every 6 months that has been shown to significantly reduce risk of vertebral-, nonvertebral-, and hip fracture in postmenopausal women. Bazedoxifene, an estrogen agonist/antagonist, has significantly reduced the risk of vertebral fracture in postmenopausal women; a post hoc analysis showed reduction in risk of nonvertebral fracture in high-risk women.