New treatment modalities in osteoporosis
1Department of Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105-1299 , USA. ecanalis@stfranciscare.org
Objective:
To describe recently discovered agents for the management of osteoporosis.
Methods:
A literature review (PubMed search) was conducted to identify agents at various stages of development for osteoporosis treatment. Agents under study or review for approval were included.
Results:
In menopause, bone remodeling is increased, and agents that suppress bone resorption can stabilize bone mass. In contrast, agents that target the osteoblast can increase bone formation and bone mass. Novel antiresorptive agents can target the formation or the activity of osteoclasts. They include denosumab, an antibody to receptor activated nuclear factor κB; new selective estrogen receptor modulators, such as bazedoxifene; and cathepsin K inhibitors, such as odanacatib. Src kinase inhibitors are in the early phases of development. Parathyroid hormone is the only approved anabolic agent for the treatment of osteoporosis. Novel anabolic therapies for osteoporosis may include the use of factors with anabolic properties for bone or the neutralization of growth factor antagonists. Recent discoveries have demonstrated that the Wnt/β-catenin signaling pathway has a central role in osteoblastic cell differentiation. Antibodies to Wnt antagonists, such as sclerostin, are under development as new therapeutic approaches for osteoporosis. Anabolic therapies have the potential to enhance bone mass, but their long-term safety must be proven.
Conclusions:
New developments in the treatment of osteoporosis include novel antiresorptive and anabolic agents. Their success will depend on their long-term effectiveness and safety profile.
Insights
New osteoporosis treatments include novel agents that reduce bone resorption and promote bone formation. Long-term effectiveness and safety are key for these emerging osteoporosis management strategies.
Area of Science:
- Bone biology and pharmacology
- Endocrinology
- Gerontology
Background:
- Menopause increases bone remodeling, necessitating treatments to stabilize bone mass.
- Osteoporosis management requires agents that either suppress bone resorption or enhance bone formation.
- Current research focuses on novel therapeutic targets for osteoporosis.
Purpose of the Study:
- To review recently discovered agents for osteoporosis management.
- To identify treatments in development for osteoporosis.
- To explore novel antiresorptive and anabolic therapies.
Main Methods:
- Literature review utilizing PubMed.
- Inclusion of agents under study or review for approval.
- Analysis of emerging osteoporosis treatment modalities.
Main Results:
- Novel antiresorptive agents include denosumab, selective estrogen receptor modulators (e.g., bazedoxifene), and cathepsin K inhibitors (e.g., odanacatib).
- Parathyroid hormone is the sole approved anabolic agent; novel anabolic therapies target bone-forming factors or Wnt signaling.
- Antibodies to Wnt antagonists like sclerostin are under development for osteoporosis treatment.
Conclusions:
- Emerging osteoporosis treatments encompass novel antiresorptive and anabolic agents.
- Long-term efficacy and safety profiles will determine the success of these new therapies.
- Continued research into bone remodeling pathways offers new therapeutic avenues.
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:40Bone Remodeling
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:31Bone Remodeling and Repair
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...