title: Bone forming agents for the management of osteoporosis.
abstract: Osteoporotic fractures are a major cause of morbidity in the population. Antiresorptive agents have been, for more than 15 years, the mainstay of osteoporosis treatment worldwide. However, these medications provide only limited fracture reduction and may be linked to skeletal and non-skeletal long-term safety concerns. Therefore, some patients are considered candidates for bone-forming agents because they remain severely osteoporotic or because they failed antiresorptive therapy. Over the last decade, a particular interest was shown in the development of medications able to increase osteoblasts number, lifespan or activity, hence stimulating bone formation Peptides from the parathyroid hormone family and strontium ranelate were shown to significantly reduce fracture rates. The European Medicines Agency recently confirmed that strontium ranelate is the treatment of choice for patients with severe osteoporosis, men and women, without cardiovascular contra-indications for whom other anti-osteoporosis medications are inappropriate. New therapeutic options, including monoclonal antibodies against sclerostin seem to be promising but their role in the armamentarium of osteoporosis will depend on the results of the current phase 3 studies, assessing anti-fracture efficacy and long-term safety.
authors.affiliation: Department of Public Health, Epidemiology and Health Economics, CHU Sart Tilman, University of Liège, Liège, Belgium - jyreginster@ulg.ac.be.
authors.forename: J Y
authors.initials: JY
authors.lastname: Reginster
authors.forename: A
authors.initials: A
authors.lastname: Neuprez
authors.forename: Ch
authors.initials: Ch
authors.lastname: Beaudart
authors.forename: F
authors.initials: F
authors.lastname: Buckinx
authors.forename: J
authors.initials: J
authors.lastname: Slomian
authors.forename: S
authors.initials: S
authors.lastname: Disteche
authors.forename: O
authors.initials: O
authors.lastname: Bruyere
mesh_terms: D048868:Adaptor Proteins, Signal Transducing; D000368:Aged; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019485:Bone Morphogenetic Proteins / Q000276:immunology; D001862:Bone Resorption; D005060:Europe; D005260:Female; D005819:Genetic Markers / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000188:drug therapy* / Q000517:prevention & control*; D010281:Parathyroid Hormone / Q000627:therapeutic use; D019379:Teriparatide / Q000627:therapeutic use; D013876:Thiophenes / Q000627:therapeutic use
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D000911:Antibodies, Monoclonal; D050071:Bone Density Conservation Agents; D019485:Bone Morphogenetic Proteins; D005819:Genetic Markers; D010281:Parathyroid Hormone; C422903:SOST protein, human; D013876:Thiophenes; C081587:strontium ranelate; D019379:Teriparatide; C557282:romosozumab