Interní Med. 2012; 14(8-9): 309-311

New perspectives of the treatment of osteoporosis

MUDr.Dana Michalská, Ph.D.

Osteocentrum, II. interní klinika 1. LF UK a VFN Praha

The bone loss after menopause contributes to increased bone resorption (due to estrogen deficiency and vitamin D deficiency in the

elderly) and decreasing with age reduced activity of osteoblasts and bone formation. The agents that suppress bone resorption can

stabilize bone mass, but do not stimulate bone formation and do not prevent loss of bone quality due to aging. In contrast, agents

that target the osteoblast can increase bone formation and bone mass. Novel antiresorptive agents focus attention on effective and

revesible effect on osteoclastogenesis and osteoclast aktivity (they include denosumab, an antibody for receptor activator of nuclear

factor kappa B ligand) or on selective suppression of osteoclast aktivity without attenuation of osteoblast aktivity (cathepsin K inhibitors,

such as odanacatib, and Src kinase inhibitors). Novel anabolic therapies for osteoporosis may include the use of factors with direct

anabolic properties for bone or the neutralization of growth factor antagonists. The Wnt/β-catenin signaling pathway has a central role

in osteoblastic cell differentiation. Antibodies to Wnt antagonists, such as sclerostin, are still far in the development and has been going

phase II study in humans. Anabolic therapies have the potencial to enhance bone mass, but their long-term safety must be proven.

Keywords: osteoporosis, denosumab, odanacatib, sclerostin antibody

Published: September 20, 2012  Show citation