Osteoporosis therapy: a novel insight from natural homeostatic system in the skeleton

Osteoporos Int. 2015 Feb;26(2):443-7. doi: 10.1007/s00198-014-2923-y. Epub 2014 Oct 7.

Abstract

The skeleton normally responds to mechanical environment to maintain the resulting elastic deformation (strain) of bone, while increased bone strength by an osteoporosis drug results in decreased bone strain. Thus, it can be hypothesized that the effect of osteoporosis therapy is limited by natural homeostatic system in the skeleton. This logic is consistent with the fact that there exists a powerful effect that returns bone mass to its pre-treatment level after the withdrawal of treatment with osteoporosis agents. The present hypothesis provides a new significant insight into the mechanisms by which osteoporosis drugs improve bone fragility. Here we briefly discuss the effects of teriparatide, romosozumab, and odanacatib on bones in animals and humans.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology*
  • Biphenyl Compounds / pharmacology*
  • Bone Density Conservation Agents / pharmacology*
  • Bone Remodeling / drug effects*
  • Bone Resorption / drug therapy
  • Humans
  • Osteoporosis / drug therapy*
  • Stress, Mechanical
  • Teriparatide / pharmacology*

Substances

  • Antibodies, Monoclonal
  • Biphenyl Compounds
  • Bone Density Conservation Agents
  • Teriparatide
  • romosozumab
  • odanacatib