Schwarz Peter, Jørgensen Niklas Rye, Abrahamsen Bo
Copenhagen University Hospital, Research Centre of Ageing and Osteoporosis, Department of Medicine , Glostrup , Denmark.
Expert Opin Drug Discov. 2014 Mar;9(3):245-53. doi: 10.1517/17460441.2014.884067. Epub 2014 Feb 4.
The metabolic bone disease osteoporosis is a growing health and health-economic problem worldwide. Bisphosphonates are the most widely used antiresorptive medication and the de facto gold standard in fracture prophylaxis all over the world, in conjunction with calcium and vitamin D supplementation. Several new medications for the treatment of postmenopausal osteoporosis are in the pipeline.
The authors present the most recent studies on new and current antiresorptive as well as anabolic drugs. Specifically, the authors present the current knowledge on drugs directed against cathepsin K and sclerostin as well as the new pathways of interest from preclinical studies.
New scientific results have identified novel signaling pathways as potential targets for future development of anti-osteoporotic drugs. The treatments close to marketing at the moment are odanacatib and romosozumab and these are both promising new medications based on bone mineral density results, safety profile and administration. Theoretically, romosozumab may hold the potential to be a drug to 'cure' even advanced stages of osteoporosis with short-term treatment. However, safety, fracture data and cost are key elements that will determine the extent of use.
代谢性骨病骨质疏松症在全球范围内是一个日益严重的健康和健康经济问题。双膦酸盐是应用最广泛的抗吸收药物，在全世界与补充钙和维生素D一起，是预防骨折的事实上的金标准。几种治疗绝经后骨质疏松症的新药正在研发中。
作者介绍了关于新型和现有抗吸收以及促合成代谢药物的最新研究。具体而言，作者介绍了针对组织蛋白酶K和硬化蛋白的药物的现有知识以及临床前研究中感兴趣的新途径。
新的科学成果已确定了新的信号通路作为未来抗骨质疏松药物开发的潜在靶点。目前接近上市的治疗药物是odanacatib和romosozumab，基于骨密度结果、安全性和给药方式，这两种都是有前景的新药。理论上，romosozumab可能有潜力成为一种通过短期治疗“治愈”甚至晚期骨质疏松症的药物。然而，安全性、骨折数据和成本是将决定使用范围的关键因素。
