[Osteoporosis therapy - Update 2025, Part 1: Antiresorptive and osteoanabolic therapy options]

Osteoporosis is a chronic disease that requires lifelong therapy management that includes both preventive measures and pharmacological approaches. The medical treatment of osteoporosis has changed considerably in recent years, particularly due to the availability of new substances, especially osteoanabolic drugs. The wide range of antiresorptive (estrogens, raloxifene, bisphosphonates, denosumab) and osteoanabolic (teriparatide, romosozumab) preparations for the treatment of osteoporosis makes it possible today to use them in a targeted manner based on the individual fracture risk. The uncertainty in their use can contribute to the underuse and lack of treatment of patients with osteoporosis, especially patients with a high fracture risk. This review article will summarize the mechanisms of action and clinical efficacy of antiresorptive and, in particular, anabolic agents and discuss its value for osteoporosis therapy.