title: Odanacatib for the treatment of osteoporosis.
abstract: BACKGROUND
  Osteoporosis and fragility fractures are important public health concerns. Cathepsin K inhibitors, including odanacatib , are a novel class of medications for osteoporosis whose mechanism of action is to directly inhibit bone resorption without killing osteoclasts, thereby permitting the complex coupling between bone resorption and formation to continue.
  
  
  METHODS
  The physiological basis for the mechanism of action of cathepsin K inhibitors is covered in addition to a review of the preclinical, Phase I, Phase II and preliminary Phase III trial data of odanacatib.
  
  
  CONCLUSIONS
  Evidence suggests that odanacatib has similar efficacy to bisphosphonates at increasing bone mineral density and decreasing risk of fragility fractures. Although odanacatib may preferentially inhibit bone resorption more than formation, the clinical significance of this difference in mechanism of action is not yet known. A careful analysis of the Phase III trial data is needed with specific attention to adverse events.
authors.affiliation: University of Toronto, Department of Medicine , 200 Elizabeth Street, 7 Eaton North Room 221, Toronto, Ontario M5G 2C4 , Canada +1 416 340 4301 ; +1 416 340 4105 ; angela.cheung@uhn.ca.
authors.forename: Miranda K
authors.initials: MK
authors.lastname: Boggild
authors.forename: Olga
authors.initials: O
authors.lastname: Gajic-Veljanoski
authors.forename: Heather
authors.initials: H
authors.lastname: McDonald-Blumer
authors.forename: Rowena
authors.initials: R
authors.lastname: Ridout
authors.forename: Lianne
authors.initials: L
authors.lastname: Tile
authors.forename: Robert
authors.initials: R
authors.lastname: Josse
authors.forename: Angela M
authors.initials: AM
authors.lastname: Cheung
mesh_terms: D000818:Animals; D001713:Biphenyl Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000188:drug therapy; D056657:Cathepsin K / Q000037:antagonists & inhibitors; D002986:Clinical Trials as Topic; D004164:Diphosphonates / Q000627:therapeutic use; D050723:Fractures, Bone / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy* / Q000503:physiopathology; D012306:Risk
chemical_list: D001713:Biphenyl Compounds; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D056657:Cathepsin K; C527128:odanacatib
keywords: cathepsin K inhibitor; odanacatib; osteoporosis