Status of drug development for the prevention and treatment of osteoporosis.
BACKGROUND
The metabolic bone disease osteoporosis is a growing health and health-economic problem worldwide. Bisphosphonates are the most widely used antiresorptive medication and the de facto gold standard in fracture prophylaxis all over the world, in conjunction with calcium and vitamin D supplementation. Several new medications for the treatment of postmenopausal osteoporosis are in the pipeline.


METHODS
The authors present the most recent studies on new and current antiresorptive as well as anabolic drugs. Specifically, the authors present the current knowledge on drugs directed against cathepsin K and sclerostin as well as the new pathways of interest from preclinical studies.


CONCLUSIONS
New scientific results have identified novel signaling pathways as potential targets for future development of anti-osteoporotic drugs. The treatments close to marketing at the moment are odanacatib and romosozumab and these are both promising new medications based on bone mineral density results, safety profile and administration. Theoretically, romosozumab may hold the potential to be a drug to 'cure' even advanced stages of osteoporosis with short-term treatment. However, safety, fracture data and cost are key elements that will determine the extent of use.
Copenhagen University Hospital, Research Centre of Ageing and Osteoporosis, Department of Medicine , Glostrup , Denmark.
Peter
P
Schwarz
Niklas Rye
NR
Jørgensen
Bo
B
Abrahamsen
D048868:Adaptor Proteins, Signal Transducing; D045930:Anabolic Agents / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019485:Bone Morphogenetic Proteins / Q000037:antagonists & inhibitors; D056657:Cathepsin K / Q000037:antagonists & inhibitors; D015195:Drug Design; D005819:Genetic Markers; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy* / Q000517:prevention & control
D048868:Adaptor Proteins, Signal Transducing; D045930:Anabolic Agents; D000911:Antibodies, Monoclonal; D001713:Biphenyl Compounds; D050071:Bone Density Conservation Agents; D019485:Bone Morphogenetic Proteins; D005819:Genetic Markers; C422903:SOST protein, human; C557282:romosozumab; D056657:Cathepsin K; C527128:odanacatib