New Therapies for Osteoporosis

Osteoporosis is a growing health concern in the United States, with an enormous impact on morbidity and mortality. Despite published guidelines to aid clinicians in its management, several controversies remain. Many trials evaluate surrogate measures of bone strength rather than more clinically relevant outcomes, including fracture. Furthermore, the role of combination and sequential therapy remains unclear. Limited data are available regarding appropriate duration of therapy, management of osteoporosis in men, and treatment of glucocorticoid-induced osteoporosis. The development of unique therapeutic agents could potentially revolutionize the treatment of osteoporosis. Once yearly zoledronic acid may provide advantages over existing therapies. Because of limitations with existing selective estrogen receptor modulators, the search for agents with better efficacy and safety profiles has led to the development of several new medications within this class. Finally, denosumab, a monoclonal antibody to receptor activator for nuclear factor-kappa B ligand, also represents a novel therapeutic option for osteoporosis.