Osteoporosis is a common disease characterised by a systemic impairment of bone mass
and microarchitecture that results in fragility fractures. With an ageing population,
the medical and socioeconomic effect of osteoporosis, particularly postmenopausal
osteoporosis, will increase further. A detailed knowledge of bone biology with molecular
insights into the communication between bone-forming osteoblasts and bone-resorbing
osteoclasts and the orchestrating signalling network has led to the identification
of novel therapeutic targets. Novel treatment strategies have been developed that
aim to inhibit excessive bone resorption and increase bone formation. The most promising
novel treatments include: denosumab, a monoclonal antibody for receptor activator
of NF-κB ligand, a key osteoclast cytokine; odanacatib, a specific inhibitor of the
osteoclast protease cathepsin K; and antibodies against the proteins sclerostin and
dickkopf-1, two endogenous inhibitors of bone formation. This overview discusses these
novel therapies and explains their underlying physiology.
Copyright © 2011 Elsevier Ltd. All rights reserved.