Experts hash out the current direction of osteoporosis treatments

Given worldwide increases in both osteoporosis diagnoses and treatment options, a group of endocrinologists and bone health experts recently published a report summarizing the current state of osteoporosis therapy and research.

The study, whose authors hail from the Mayo Clinic and Germany's Dresden Technical University Medical Center, appears in the journal The Lancet.

It points to three novel osteoporosis medications as being particularly promising in slowing bone loss or boosting bone formation. They are denosumab, odanacatib and antibodies against bone formation-inhibiting proteins like sclerostin and dickkopf-1.

Denosumab is a monoclonal antibody that was approved by the U.S. Food and Drug Administration in 2010 for use among postmenopausal women with osteoporosis, according to the website Genetic Engineering and Biotechnology News.

This medication targets the RANK ligand, which is a protein that signals specialized cells - called osteoclasts - to break down bone tissue. With the RANK ligand effectively blocked, weakened bones can naturally increase their mass without the devastating interference of osteoclastic overactivity.

Odanacatib operates along similar lines, the team wrote. However, instead of preventing molecular messengers from initiating the breakdown of bone minerals, this medication inhibits one of the enzymes that does the actual work of bone resorption.

Researchers explained that odanacatib prevents an enzyme called cathepsin K from breaking down elastin, collagen and gelatin, three proteins that are essential to healthy bone mass.

Finally, the review noted that antibodies targeting the proteins sclerostin and dickkopf-1 have shown positive results in clinical trials. Both proteins are negative regulators of bone mass, meaning that their increased presence is associated with lower bone mineral density.

By neutralizing these two molecules, researchers are providing osteoporosis patients with one more way to increase bone strength and mass.

"The development of these many novel compounds is an excellent example of the investment needed in basic research to identify specific pathways that can be effectively targeted to treat and possibly reverse osteoporosis," the research group concluded.

In the U.S., 44 million people suffer from either low bone mass or osteoporosis, according to the National Osteoporosis Foundation.
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