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Future directions for new medical entities in osteoporosis.

Abstract
Odanacatib, a selective cathepsin K inhibitor, decreases bone resorption, whereas osteoclast number increases and bone formation is maintained, perhaps even increased on some cortical surfaces. In a phase 2 clinical trial, post-menopausal women receiving odanacatib presented a sustained reduction of bone resorption markers, whereas procollagen type 1 N-terminal propeptide returned to normal. In turn areal bone mineral density increased continuously at both spine and hip for up to 5 years. Blosozumab and romosozumab are sclerostin neutralizing antibodies that exert potent anabolic effects on both trabecular and cortical compartments. A phase 2 clinical trial has reported areal bone mineral density gains at spine and hip that were greater with romosozumab compared with placebo, but also with teriparatide. It also showed that antagonizing sclerostin results in a transient stimulation of bone formation but progressive inhibition of bone resorption. Other new medical entities that are promising for the treatment of osteoporosis include abaloparatide, a parathyroid hormone-related analogue with improved bone formation-resorption ratio.
AuthorsSerge Ferrari
JournalBest practice & research. Clinical endocrinology & metabolism (Best Pract Res Clin Endocrinol Metab) Vol. 28 Issue 6 Pg. 859-70 (Dec 2014) ISSN: 1878-1594 [Electronic] Netherlands
PMID25432357 (Publication Type: Journal Article, Review)
CopyrightCopyright © 2014 Elsevier Ltd. All rights reserved.
Chemical References
  • Adaptor Proteins, Signal Transducing
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Biphenyl Compounds
  • Bone Morphogenetic Proteins
  • Genetic Markers
  • Parathyroid Hormone-Related Protein
  • SOST protein, human
  • romosozumab
  • blosozumab
  • abaloparatide
  • Cathepsin K
  • odanacatib
Topics
  • Adaptor Proteins, Signal Transducing
  • Antibodies, Monoclonal (pharmacology)
  • Antibodies, Monoclonal, Humanized (pharmacology)
  • Biphenyl Compounds (pharmacology)
  • Bone Morphogenetic Proteins (antagonists & inhibitors)
  • Cathepsin K (antagonists & inhibitors)
  • Genetic Markers
  • Humans
  • Osteoporosis (drug therapy)
  • Parathyroid Hormone-Related Protein (pharmacology)

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