Bone forming agents for the management of osteoporosis

Osteoporotic fractures are a major cause of morbidity in the population. Anti-resorptive agents have been, for more than 15 years, the mainstay of osteoporosis treatment worldwide. However, these medications provide only limited fracture reduction and may be linked to skeletal and non-skeletal long-term safety concerns. Therefore, some patients are considered candidates for bone-forming agents because they remain severely osteoporotic or because they failed antiresorptive therapy. Over the last decade, a particular interest was shown in the developmentofmedicationsabletoincreaseosteoblastsnumber,lifespan or activity, hence stimulating bone formation Peptides from the parathyroid hormone family and strontium ranelate were shown to significantly reduce fracture rates but strontium ranelate is no longer an option for treating osteoporosis because of its safety profile. New therapeutic options, including monoclonal antibodies against sclerostin seem to be promising but their role in the armamentarium of osteoporosis will depend on the results of the current phase 3 studies, assessing antifracture efficacy and long-term safety.