Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing 100730, China.
Curr Pharm Des. 2017;23(41):6298-6301. doi: 10.2174/1381612823666170516124659.
Bone loss is common in clinical practice, such as health assessment of postmenopausal women, treatment of tumor metastasis, side-effects of glucocorticoids, and skeletal manifestations of inflammatory diseases. The imbalance of remodeling between bone resorption and bone formation, the pathophysiological basis of bone loss, increases bone fragility. The treatment of bone loss is mainly carried out from the treatment of osteoporosis. There are various pharmacological therapies for bone loss, which will be introduced in 3 aspects, including antiresorptive agents, anabolic agents and new medications. Each kind of medication has its advantages, shortcomings and side-effects. Antiresorptive agents are widely applied in the treatment of bone loss, but can lead to overall decrease of bone turnover rate. Anabolic agents, mainly PTH, are usually combined with other anti-resorptive drugs, and PTHrP might be a promising pure anabolic agent for osteoporosis. In recent years, some novel therapies have been raised and tested in clinical trials which can be promising choices available for osteoporosis treatment. Future drug targets will mainly come from RANK-RANKL-OPG system and Wnt/β-catenin signaling pathway., and the pre-existing drugs could be explored in new patterns.
骨质流失在临床实践中很常见，例如绝经后妇女的健康评估、肿瘤转移的治疗、糖皮质激素的副作用以及炎症性疾病的骨骼表现。破骨细胞和成骨细胞之间的重塑失衡，即骨质流失的病理生理基础，增加了骨骼的脆弱性。骨质流失的治疗主要从骨质疏松症的治疗开始。骨质流失有多种药物治疗方法，将从抗吸收剂、合成代谢剂和新药 3 个方面进行介绍。每种药物都有其优点、缺点和副作用。抗吸收剂在骨质流失的治疗中广泛应用，但会导致骨转换率全面下降。合成代谢剂主要是 PTH，通常与其他抗吸收药物联合使用，而 PTHrP 可能是一种有前途的纯合成代谢剂，用于治疗骨质疏松症。近年来，一些新的治疗方法已经在临床试验中提出并进行了测试，它们可能是骨质疏松症治疗的有前途的选择。未来的药物靶点主要来自 RANK-RANKL-OPG 系统和 Wnt/β-catenin 信号通路，现有的药物可以在新模式中进行探索。
