Anti-resorptive therapies for osteoporosis

The treatment of osteoporosis is largely based around the use of agents that inhibit bone resorption by osteoclasts. The main classes of anti-resorptives currently in use are calcium, bisphosphonates, estrogen, selective estrogen receptor modulators (SERMs) and calcitonin. Novel agents in developmen...

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Bibliographic Details
Published in:Seminars in cell & developmental biology 2008-10, Vol.19 (5), p.473-478
Main Author: Reid, Ian R.
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - therapeutic use
Bisphosphonate
Bone Density Conservation Agents - therapeutic use
Bone Resorption - prevention & control
Calcium
Calcium - therapeutic use
Cathepsin K
Cathepsins - antagonists & inhibitors
Denosumab
Diphosphonates - therapeutic use
Estrogen
Female
Fractures, Bone - drug therapy
Humans
Models, Biological
Osteoblasts - physiology
Osteoclasts - drug effects
Osteoclasts - physiology
Osteoporosis - drug therapy
Raloxifene
RANK Ligand - metabolism
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Summary:The treatment of osteoporosis is largely based around the use of agents that inhibit bone resorption by osteoclasts. The main classes of anti-resorptives currently in use are calcium, bisphosphonates, estrogen, selective estrogen receptor modulators (SERMs) and calcitonin. Novel agents in development are: inhibitors of the osteoclast enzyme, cathepsin K; and a monoclonal antibody against receptor activator of NFκB-ligand (RANKL), a factor made by osteoblasts which stimulates osteoclast development. Potent anti-resorptive agents decrease numbers of vertebral fractures by about 50%, and non-vertebral fractures by only 25%. Whether the newer agents can improve on this remains to be seen, though it is possible that anabolic agents which increase bone mass more substantially will be needed to achieve greater reductions in all fracture numbers.
ISSN:1084-9521
1096-3634
DOI:10.1016/j.semcdb.2008.08.002