Current Status of Bone-Forming Therapies for the Management of Osteoporosis

TY - JOUR

T1 - Current Status of Bone-Forming Therapies for the Management of Osteoporosis

AU - Sølling, Anne Sophie

AU - Harsløf, Torben

AU - Langdahl, Bente

PY - 2019/7

Y1 - 2019/7

N2 - In patients with osteoporosis and severely reduced bone mass and/or recurring fractures, antiresorptive therapy may not be the optimal first-line treatment. Two recent clinical trials comparing bone-forming treatment with antiresorptive therapy have demonstrated that bone-forming treatment is superior in reducing the fracture risk in patients with severe osteoporosis. All of the currently available bone-forming agents-teriparatide, abaloparatide, and romosozumab-increase bone mineral density (BMD) and reduce the fracture risk; however, the effect wears off with time and treatment is therefore only transient. Thus, a bone-forming therapy should be followed by antiresorptive treatment with a bisphosphonate or denosumab. The BMD response to bone-forming treatment is reduced in patients previously treated with antiresorptive drugs; however, based on the findings of the VERO trial, the anti-fracture efficacy of bone-forming treatment in comparison with antiresorptives seems to be preserved. This review provides an overview of the existing bone-forming therapies for osteoporosis including considerations of sequential and combination therapy.

AB - In patients with osteoporosis and severely reduced bone mass and/or recurring fractures, antiresorptive therapy may not be the optimal first-line treatment. Two recent clinical trials comparing bone-forming treatment with antiresorptive therapy have demonstrated that bone-forming treatment is superior in reducing the fracture risk in patients with severe osteoporosis. All of the currently available bone-forming agents-teriparatide, abaloparatide, and romosozumab-increase bone mineral density (BMD) and reduce the fracture risk; however, the effect wears off with time and treatment is therefore only transient. Thus, a bone-forming therapy should be followed by antiresorptive treatment with a bisphosphonate or denosumab. The BMD response to bone-forming treatment is reduced in patients previously treated with antiresorptive drugs; however, based on the findings of the VERO trial, the anti-fracture efficacy of bone-forming treatment in comparison with antiresorptives seems to be preserved. This review provides an overview of the existing bone-forming therapies for osteoporosis including considerations of sequential and combination therapy.

KW - ALENDRONATE

KW - ANTIRESORPTIVE THERAPY

KW - BISPHOSPHONATE-RELATED OSTEONECROSIS

KW - MINERAL DENSITY

KW - PARATHYROID-HORMONE 1-34

KW - POSTMENOPAUSAL WOMEN

KW - TERIPARATIDE RHPTH(1-34)

KW - TYPE-1 RECEPTOR

KW - VERTEBRAL FRACTURES

KW - ZOLEDRONIC ACID

KW - Bone Resorption/drug therapy

KW - Denosumab/therapeutic use

KW - Osteoporosis/drug therapy

KW - Humans

KW - Antibodies, Monoclonal/therapeutic use

KW - Teriparatide/therapeutic use

KW - Bone Density Conservation Agents/therapeutic use

KW - Diphosphonates/therapeutic use

KW - Randomized Controlled Trials as Topic

KW - Osteogenesis/drug effects

KW - Parathyroid Hormone-Related Protein/therapeutic use

KW - Clinical Trials, Phase III as Topic

KW - Bone Density/drug effects

KW - Drug Therapy, Combination

U2 - 10.1007/s40266-019-00675-8

DO - 10.1007/s40266-019-00675-8

M3 - Review

C2 - 31066015

SN - 1170-229X

VL - 36

SP - 625

EP - 638

JO - Drugs & Aging

JF - Drugs & Aging

IS - 7

ER -