[Present development of new drugs for osteoporosis].
Bisphosphonates are widely used, though gastrointestinal tolerance is a problem on daily administration. Alendronate 35 mg administered once weekly is as effective at increasing bone mineral density (BMD) as 5 mg/day in the treatment of osteoporosis. Once weekly regimen will be soon available in Japan and can reduce adverse events. Injection therapies may also circumvent this, although this introduces the smaller problem of acute phase reactions. New generation bisphosphonates (milodronate, ibandronate and zoledronate) along with anti-receptor activator of nuclear factor-kappaB ligand (RANKL) antibody are promising and eagerly developed for the treatment of osteoporosis. Raloxifene appears to have a superior safety profile to hormone replacement therapy (HRT), though its efficacy on bone may be limited, so that various new generation of selective estrogen receptor modulator (SERMs) is now underdeveloped. Anabolic agents such as teriparatide and strontium ranelate have marked effects on BMD and subsequent reduction on fracture risk. While none of these options is suitable for everyone, the range of future available therapies does mean that most patients can find an intervention that is effective and acceptable.
Wada
Seiki
S
Department of Clinical Science, Faculty of Pharmaceutical Sciences, Josai International Univesity.
D000906:Antibodies / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002352:Carrier Proteins / Q000276:immunology; D004164:Diphosphonates / Q000627:therapeutic use; D017277:Drug Approval; D006801:Humans; D008562:Membrane Glycoproteins / Q000276:immunology; D010024:Osteoporosis / Q000188:drug therapy*; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use
D000906:Antibodies; D050071:Bone Density Conservation Agents; D002352:Carrier Proteins; D004164:Diphosphonates; D008562:Membrane Glycoproteins; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D020845:Selective Estrogen Receptor Modulators; C505686:TNFRSF11A protein, human; C505688:TNFSF11 protein, human