Department of Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut 06105-1299 , USA.
Endocr Pract. 2010 Sep-Oct;16(5):855-63. doi: 10.4158/EP10048.RA.
To describe recently discovered agents for the management of osteoporosis.
A literature review (PubMed search) was conducted to identify agents at various stages of development for osteoporosis treatment. Agents under study or review for approval were included.
In menopause, bone remodeling is increased, and agents that suppress bone resorption can stabilize bone mass. In contrast, agents that target the osteoblast can increase bone formation and bone mass. Novel antiresorptive agents can target the formation or the activity of osteoclasts. They include denosumab, an antibody to receptor activated nuclear factor κB; new selective estrogen receptor modulators, such as bazedoxifene; and cathepsin K inhibitors, such as odanacatib. Src kinase inhibitors are in the early phases of development. Parathyroid hormone is the only approved anabolic agent for the treatment of osteoporosis. Novel anabolic therapies for osteoporosis may include the use of factors with anabolic properties for bone or the neutralization of growth factor antagonists. Recent discoveries have demonstrated that the Wnt/β-catenin signaling pathway has a central role in osteoblastic cell differentiation. Antibodies to Wnt antagonists, such as sclerostin, are under development as new therapeutic approaches for osteoporosis. Anabolic therapies have the potential to enhance bone mass, but their long-term safety must be proven.
New developments in the treatment of osteoporosis include novel antiresorptive and anabolic agents. Their success will depend on their long-term effectiveness and safety profile.
描述最近发现的用于骨质疏松症治疗的药物。
对骨质疏松症治疗的各个阶段的药物进行了文献回顾（PubMed 搜索）。研究或审查中的药物包括在内。
在绝经期间，骨重塑增加，抑制骨吸收的药物可以稳定骨量。相比之下，针对成骨细胞的药物可以增加骨形成和骨量。新型抗吸收药物可以靶向破骨细胞的形成或活性。它们包括针对核因子 κB 受体激活的抗酒石酸酸性磷酸酶 4（Denosumab）的抗体；新的选择性雌激素受体调节剂，如 bazedoxifene；和组织蛋白酶 K 抑制剂，如odanacatib。Src 激酶抑制剂处于早期开发阶段。甲状旁腺激素是治疗骨质疏松症的唯一批准的合成代谢药物。用于骨质疏松症的新型合成代谢疗法可能包括使用具有成骨特性的因子或中和生长因子拮抗剂。最近的发现表明 Wnt/β-连环蛋白信号通路在成骨细胞分化中具有核心作用。针对 Wnt 拮抗剂（如硬化素）的抗体正在开发中，作为骨质疏松症的新治疗方法。合成代谢疗法有增强骨量的潜力，但必须证明其长期安全性。
骨质疏松症治疗的新进展包括新型抗吸收和合成代谢药物。它们的成功将取决于其长期有效性和安全性。
