Promising New Agents in Osteoporosis

Currently marketed inhibitors of bone resorption or stimulators of bone formation have significantly contributed to a better preventive and therapeutic approach to postmenopausal and senile osteoporosis. However, none of the available compounds has unequivocally demonstrated an ability to fully prevent the occurrence of new vertebral or peripheral osteoporotic fractures once the disease is established. Therefore, several new medications are being developed, with the aim of providing a better risk-benefit profile and/or a more favourable cost-utility assessment than available drugs. Potential inhibitors of bone resorption include specific inhibitors of the osteoclast's proton pump, inhibitors of prostaglandins or nitric oxide donors. Stimulators of osteoblastic activity and subsequent bone formation might be obtained by strontium salts, peptides of the parathyroid hormone family, growth hormone and insulin-like growth factors or bone morphogenetic proteins. Most of these compounds are now undergoing phase II/III development programmes, and results evaluating their potential benefit should be available within 1 to 5 years.