title: Investigational drugs for fracture healing: preclinical & clinical data.
abstract: BACKGROUND
  The need for fracture healing enhancement for the management of fracture complications such as non-union and for the achievement of early function in fracture patients is constantly increasing. Therefore, the development and evaluation of novel pharmaceutical agents is mandatory in order to accelerate the process and increase bone union rates.
  
  
  METHODS
  This review summarizes the most recent knowledge on the pharmacological enhancement of fracture repair. It provides a synopsis of the most important preclinical and clinical studies published over the past five years on long bone fracture healing.
  
  
  CONCLUSIONS
  To date, limited drugs seem to have the potential for clinical use in fracture healing enhancement and the field is progressing very slowly. Among anti-osteoporotic drugs, only PTH and anti-sclerostin antibodies have such a potential but further research is needed before clinical use. The same applies also to BMPs, the use of which still carries major drawbacks that should be overcome before their widespread clinical utilization. Other drugs and growth factors, such as statins, VEGF, FGF, EPO, could be future key players in fracture healing but evidence is still lacking. Further in depth understanding of the healing process is essential in order to identify novel effective pharmacological agents.
authors.affiliation: a Biological Systems Engineering Laboratory, Department of Chemical Engineering , Imperial College London , London , UK.
authors.forename: Michail E
authors.initials: ME
authors.lastname: Klontzas
authors.affiliation: b Academic Orthopaedic Unit , Aristotle University Medical School , Thessaloniki , Greece.
authors.forename: Eustathios I
authors.initials: EI
authors.lastname: Kenanidis
authors.affiliation: a Biological Systems Engineering Laboratory, Department of Chemical Engineering , Imperial College London , London , UK.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: MacFarlane
authors.affiliation: b Academic Orthopaedic Unit , Aristotle University Medical School , Thessaloniki , Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Michail
authors.affiliation: b Academic Orthopaedic Unit , Aristotle University Medical School , Thessaloniki , Greece.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Potoupnis
authors.affiliation: c Department of Oral and Maxillofacial Surgery , London North West Healthcare NHS Trust, Northwick Park Hospital , London , UK.
authors.forename: Manolis
authors.initials: M
authors.lastname: Heliotis
authors.affiliation: a Biological Systems Engineering Laboratory, Department of Chemical Engineering , Imperial College London , London , UK.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Mantalaris
authors.affiliation: b Academic Orthopaedic Unit , Aristotle University Medical School , Thessaloniki , Greece.|d Department of Surgery and Cancer, Division of Surgery , Imperial College London , London , UK.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D000818:Animals; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use; D015507:Drugs, Investigational / Q000627:therapeutic use*; D017102:Fracture Healing / Q000187:drug effects; D050723:Fractures, Bone / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D010024:Osteoporosis / Q000188:drug therapy
chemical_list: D019485:Bone Morphogenetic Proteins; D015507:Drugs, Investigational; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Fracture healing; anti-osteoporotics; bisphosphonates; bone morphogenetic proteins/bmp; clinical; drugs; fracture repair; growth factors; preclinical; statins