Bone anabolics in osteoporosis: Actuality and perspectives  

作　　者：Andrea Montagnani 

机构地区：[1]Metabolic Bone Diseases Area,Department of Internal Medicine,Misericordia Hospital,58100 Grosseto,Italy

出　　处：《World Journal of Orthopedics》2014年第3期247-254,共8页世界骨科杂志（英文版）

摘　　要：Vertebral and nonvertebral fractures prevention is the main goal for osteoporosis therapy by inhibiting bone resorption and/or stimulating bone formation.Antiresorptive drugs decrease the activation frequency,thereby determining a secondary decrease in bone formation rate and a low bone turnover.Bisphosphonates are today’s mainstay among antiresorptive treatment of osteoporosis.Also,oral selective estrogen receptor modulators and recently denosumab have a negative effect on bone turnover.Agents active on bone formation are considered a better perspective in the treatment of severe osteoporosis.Recombinant-human parathyroid hormone(PTH)has showed to increase bone formation and significantly decrease vertebral fractures in severe patients,but with a modest effect on nonvertebral fractures.The study of Wnt signaling pathway,that induces prevalently an osteoblastic activity,opens large possibilities to antagonists of Wnt-inhibitors,such as sclerostin antibodies and dickkopf-1 antagonists,with potential effects not only on trabecular bone but also on cortical bone.Vertebral and nonvertebral fractures prevention is the main goal for osteoporosis therapy by inhibiting bone resorption and/or stimulating bone formation. Antiresorptive drugs decrease the activation frequency, thereby determining a secondary decrease in bone formation rate and a low bone turnover. Bisphosphonates are today's mainstay among antiresorptive treatment of osteoporosis. Also, oral selective estrogen receptor modulators and recently denosumab have a negative effect on bone turnover. Agents active on bone formation are considered a better perspective in the treatment of severe osteoporosis. Recombinant-human parathyroid hormone(PTH) has showed to increase bone formation and significantly decrease vertebral fractures in severe patients, but with a modest effect on nonvertebral fractures. The study of Wnt signaling pathway, that induces prevalently an osteoblastic activity, opens large possibilities to antagonists of Wnt-inhibitors, such as sclerostin antibodies and dickkopf-1 antagonists, with potential effects not only on trabecular bone but also on cortical bone.

关 键 词：ANABOLIC therapy BONE mass BONE FRACTURE OSTEOPOROSIS 

分 类 号：R580[医药卫生—内分泌]