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Current Status of Bone-Forming Therapies for the Management of Osteoporosis

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Abstract

In patients with osteoporosis and severely reduced bone mass and/or recurring fractures, antiresorptive therapy may not be the optimal first-line treatment. Two recent clinical trials comparing bone-forming treatment with antiresorptive therapy have demonstrated that bone-forming treatment is superior in reducing the fracture risk in patients with severe osteoporosis. All of the currently available bone-forming agents—teriparatide, abaloparatide, and romosozumab—increase bone mineral density (BMD) and reduce the fracture risk; however, the effect wears off with time and treatment is therefore only transient. Thus, a bone-forming therapy should be followed by antiresorptive treatment with a bisphosphonate or denosumab. The BMD response to bone-forming treatment is reduced in patients previously treated with antiresorptive drugs; however, based on the findings of the VERO trial, the anti-fracture efficacy of bone-forming treatment in comparison with antiresorptives seems to be preserved. This review provides an overview of the existing bone-forming therapies for osteoporosis including considerations of sequential and combination therapy.

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  1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark

    Anne Sophie Koldkjær Sølling, Torben Harsløf & Bente Langdahl

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  1. Anne Sophie Koldkjær Sølling
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Torben Harsløf received lecture fees from Amgen, Astra Zeneca, and Eli Lilly. Bente Langdahl is editor-in-chief of Bone Reports and associate editor of the European Journal of Endocrinology and has received research funding to her institution from Amgen and Novo Nordisk. Bente Langdahl serves on advisory boards and speaker’s bureau for Eli Lilly, Amgen, UCB, and TEVA. Anne Sophie Koldkjær Sølling has nothing to declare.

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Sølling, A.S.K., Harsløf, T. & Langdahl, B. Current Status of Bone-Forming Therapies for the Management of Osteoporosis. Drugs Aging 36, 625–638 (2019). https://doi.org/10.1007/s40266-019-00675-8

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