Pharmacological Therapy of Osteoporosis: What’s New?

• Published in: Clinical interventions in aging Vol. 15; pp. 485 - 491
• Main Authors: Iolascon, Giovanni, Moretti, Antimo, Toro, Giuseppe, Gimigliano, Francesca, Liguori, Sara, Paoletta, Marco
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Abaloparatide; Alendronate; Antibodies; antiresorptive drugs; Bisphosphonates; bone anabolic drugs; Bone density; Chronic illnesses; Chronic obstructive pulmonary disease; Clinical medicine; Denosumab; Disease prevention; Drug approval; Drug therapy; Drugs; Fractures; Fractures (Injuries); Health aspects; Health care industry; Hospital costs; Marketing; Monoclonal antibodies; Morbidity; Osteoporosis; Physiological aspects; Retirement benefits; Review; romosozumab; sequential therapy; Zoledronate; Italy; sequential therapy; romosozumab; bone anabolic drugs; antiresorptive drugs; osteoporosis; abaloparatide
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S242038

Osteoporosis and fragility fractures are relevant health issues because of their impact in terms of morbidity, mortality, and socioeconomic burden. Despite this alarming scenario, both underdiagnosis and undertreatment are common features of osteoporotic patients, particularly those who have already sustained a fragility fracture. Pharmacotherapy of osteoporosis is the main treatment option for these patients because of strong evidence about the efficacy of available drugs targeting bone metabolism. However, several issues can interfere with the effectiveness of anti-osteoporotic drugs in clinical practice, such as lack of awareness of both healthcare providers and patients, poor adherence to therapy, and safety in long-term treatment. Therefore, new therapeutic strategies have been proposed to overcome these problems, such as sequential therapy or emerging molecules mainly targeting the stimulation of bone formation. In particular, abaloparatide has been demonstrated to reduce major nonvertebral fracture risk compared with both placebo and teriparatide, although the European Medicines Agency (EMA) refused the marketing authorization because the benefits of this drug did not outweigh its risks. On the other side, EMA has recently approved romosozumab, a monoclonal antibody directed against sclerostin and the only available therapeutic option targeting Wnt signaling, as both bone-forming and antiresorptive intervention to treat osteoporosis and fragility fractures.