Endocrinol Metab.  2015 Dec;30(4):429-435. 10.3803/EnM.2015.30.4.429.

Emerging Therapies for Osteoporosis

• McClung MR

• KMID: 2169649
• DOI: http://doi.org/10.3803/EnM.2015.30.4.429

Abstract

Although several effective therapies are available for the treatment of osteoporosis in postmenopausal women and older men, there remains a need for the development of even more effective and acceptable drugs. Several new drugs that are in late-stage clinical development will be discussed. Abaloparatide (recombinant parathyroid hormone related peptide [PTHrP] analogue) has anabolic activity like teriparatide. Recent data from the phase 3 fracture prevention trial demonstrate that this agent is effective in reducing fracture risk. Inhibiting cathepsin K reduces bone resorption without decreasing the numbers or activity of osteoclasts, thereby preserving or promoting osteoblast function. Progressive increases in bone mineral density (BMD) have been observed over 5 years. Early data suggest that odanacatib effectively reduces fracture risk. Lastly, inhibiting sclerostin with humanized antibodies promotes rapid, substantial but transient increases in bone formation while inhibiting bone resorption. Marked increases in BMD have been observed in phase 2 studies. Fracture prevention studies are underway. The new therapies with novel and unique mechanisms of action may, alone or in combination, provide more effective treatment options for our patients.

Keyword

Osteoporosis; Therapy; Parathyroid hormone-related protein; Cathepsin K; Sclerostin

MeSH Terms

Antibodies, Monoclonal, Humanized
Bone Density
Bone Resorption
Cathepsin K
Female
Humans
Male
Osteoblasts
Osteoclasts
Osteogenesis
Osteoporosis*
Parathyroid Hormone-Related Protein
Teriparatide
Antibodies, Monoclonal, Humanized
Cathepsin K
Parathyroid Hormone-Related Protein
Teriparatide

Figure

• 

  Fig. 1 Bone mineral density change with odanacatib 50 mg once weekly.

• 

  Fig. 2 Bone mineral density changes at 12 months in lumbar spine and femoral neck.

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