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Novel advances in the treatment of osteoporosis

Novel advances in the treatment of osteoporosis
Novel advances in the treatment of osteoporosis
Introduction: Osteoporosis is a significant public health issue affecting over half of women aged over 50. With an aging population, its importance is set to increase further over time. Prevention of fragility fractures avoids significant mortality and morbidity as well as saving significant direct and indirect costs to the economy. In this review, we discuss existing treatments to contextualize the treatment landscape, and demonstrate how our understanding of bone pathophysiology has led to novel therapies—in the form of combinations and altered durations of existing treatments, as well as newer drug therapies.

Sources of data: PubMed and Embase were searched for randomized controlled trials of new therapies for osteoporosis. These searches were supplemented with material presented in abstract form at international meetings.

Areas of agreement: New drugs that appear promising in the treatment of osteoporosis include the cathepsin K inhibitor, monoclonal antibodies against sclerostin and parathyroid hormone-related protein analog.

Areas of controversy: Separate to the development of novel drug therapies is the issue of how best to use agents that are currently available to us; specifically which agent to choose, alone or in combination; duration of therapy; how best to identify patients at highest risk of fracture, and to ensure the highest possible adherence to medication. Many of these issues have been addressed in other excellent review papers, and will not be considered in detail here.

Growing points: As with all new treatments, we await results of long-term use and experience in ‘real life’ patient populations.

Areas timely for developing research: As alluded to above, data are urgently required regarding the optimal duration of therapy; use of combination therapy; ordering of therapies for best therapeutic effect. As stratified medicine becomes more strongly considered in all areas of therapy, its merits in osteoporosis as in other musculoskeletal conditions, is timely and valuable.
0007-1420
129-142
Chan, Christopher K.Y.
f79c96f1-ed46-4b46-a808-97a75f2aefb5
Mason, Alice
3a78776d-13b0-48b5-ba8a-e7ef5b2a057b
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Chan, Christopher K.Y.
f79c96f1-ed46-4b46-a808-97a75f2aefb5
Mason, Alice
3a78776d-13b0-48b5-ba8a-e7ef5b2a057b
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Chan, Christopher K.Y., Mason, Alice, Cooper, Cyrus and Dennison, Elaine (2016) Novel advances in the treatment of osteoporosis. British Medical Bulletin, 119 (1), 129-142. (doi:10.1093/bmb/ldw033). (PMID:27558130)

Record type: Article

Abstract

Introduction: Osteoporosis is a significant public health issue affecting over half of women aged over 50. With an aging population, its importance is set to increase further over time. Prevention of fragility fractures avoids significant mortality and morbidity as well as saving significant direct and indirect costs to the economy. In this review, we discuss existing treatments to contextualize the treatment landscape, and demonstrate how our understanding of bone pathophysiology has led to novel therapies—in the form of combinations and altered durations of existing treatments, as well as newer drug therapies.

Sources of data: PubMed and Embase were searched for randomized controlled trials of new therapies for osteoporosis. These searches were supplemented with material presented in abstract form at international meetings.

Areas of agreement: New drugs that appear promising in the treatment of osteoporosis include the cathepsin K inhibitor, monoclonal antibodies against sclerostin and parathyroid hormone-related protein analog.

Areas of controversy: Separate to the development of novel drug therapies is the issue of how best to use agents that are currently available to us; specifically which agent to choose, alone or in combination; duration of therapy; how best to identify patients at highest risk of fracture, and to ensure the highest possible adherence to medication. Many of these issues have been addressed in other excellent review papers, and will not be considered in detail here.

Growing points: As with all new treatments, we await results of long-term use and experience in ‘real life’ patient populations.

Areas timely for developing research: As alluded to above, data are urgently required regarding the optimal duration of therapy; use of combination therapy; ordering of therapies for best therapeutic effect. As stratified medicine becomes more strongly considered in all areas of therapy, its merits in osteoporosis as in other musculoskeletal conditions, is timely and valuable.

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Accepted/In Press date: 4 July 2016
e-pub ahead of print date: 24 August 2016
Published date: 9 September 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 399887
URI: https://eprints.soton.ac.uk/id/eprint/399887
ISSN: 0007-1420
PURE UUID: a5988351-1ca9-41e5-a779-e0de0a72c7ed
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 02 Sep 2016 10:20
Last modified: 15 Aug 2019 05:20

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Contributors

Author: Christopher K.Y. Chan
Author: Alice Mason
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD

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