Treatment of postmenopausal osteoporosis with odanacatib.
BACKGROUND
The market of anti-osteoporosis drugs has been declining in recent years, possibly in part due to the publicity around adverse events observed with bisphosphonates. Also, the proportion of patients with clinical fracture who receive adequate treatment remains low. So there are still unmet needs in this field. Odanacatib is a cathepsin K inhibitor currently being developed for the treatment of postmenopausal osteoporosis that could be an advance in this context.


METHODS
Odanacatib is a bone resorption inhibitor, but it preserves some degree of bone formation, which differentiates this new family of drugs from existing therapies. Odanacatib increases bone mineral density at the spine and hip, improves estimated bone strength using finite element analysis at the spine and hip as well as at the distal tibia and radius. The safety profile has been satisfactory so far. A robust antifracture efficacy has been announced when the Phase III pivotal trial was terminated after interim analysis, but we do not yet have access to the complete results.


CONCLUSIONS
Odanacatib may have an important role in future guidelines if it provides a substantial advantage compared to the effective and inexpensive current generic drugs, in terms of antifracture efficacy or safety.
Université de Lyon, Hôpital E Herriot , INSERM UMR 1033, Lyon 69437 , France +33 4 72 11 74 81 ; +33 4 72 11 74 83 ; Roland.chapurlat@inserm.fr.
Roland D
RD
Chapurlat
D000818:Animals; D001713:Biphenyl Compounds / Q000494:pharmacology* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000494:pharmacology* / Q000627:therapeutic use; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000503:physiopathology
D001713:Biphenyl Compounds; D050071:Bone Density Conservation Agents; C527128:odanacatib