Novel therapeutic options for osteoporosis.
Osteoporosis remains a significant clinical problem despite effective therapies. Many patients cannot or will not take currently available therapies. For this reason, research continues in search of more effective and more tolerable agents. Arzoxifene and TSE-424 are investigational selective estrogen receptor modulators that have been shown to be effective in animal studies and are now in clinical studies. Tibolone is a tissue-specific steroid that is currently used in Europe for the prevention and treatment of osteoporosis. Multiple studies have shown efficacy in improving bone mineral density, but no fracture studies have been conducted to date. Although studies of the effect of isoflavones on bone mineral density have been encouraging, a large multicenter study in Europe recently showed no effect of isoflavones on fractures. The investigational bisphosphonates ibandronate and zoledronic acid may offer the advantage of less frequent dosing. The newly described agent osteoprotegerin has been shown in early studies to inhibit bone turnover. Finally, the issue of efficacy of statins in bone continues to be debated with no prospective, randomized studies yet to confirm the suggestion of benefit seen in epidemiologic studies.
Biskobing
Diane M
DM
Virginia Commonwealth University/Medical College of Virginia, Richmond, Virginia 23298, USA. dmbiskob@hsc.vcu.edu
Novy
Angela M
AM
Downs
Robert
R
D000818:Animals; D018849:Controlled Clinical Trials as Topic; D004164:Diphosphonates / Q000627:therapeutic use; D004195:Disease Models, Animal; D019317:Evidence-Based Medicine; D005598:Fractures, Spontaneous / Q000209:etiology / Q000517:prevention & control; D006023:Glycoproteins / Q000627:therapeutic use; D006801:Humans; D000077557:Ibandronic Acid; D007093:Imidazoles / Q000627:therapeutic use; D009652:Norpregnenes / Q000627:therapeutic use; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D053244:Osteoprotegerin; D010880:Piperidines / Q000627:therapeutic use; D018160:Receptors, Cytoplasmic and Nuclear / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use; D000077211:Zoledronic Acid
D004164:Diphosphonates; D006023:Glycoproteins; D007093:Imidazoles; D009652:Norpregnenes; D053244:Osteoprotegerin; D010880:Piperidines; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; D020845:Selective Estrogen Receptor Modulators; C506030:TNFRSF11B protein, human; D013876:Thiophenes; D000077211:Zoledronic Acid; C115121:LY 353381; C027385:tibolone; D000077557:Ibandronic Acid