The role of osteoanabolic agents in the management of patients with osteoporosis

ABSTRACT

Reducing fracture risk is the objective of osteoporosis treatment. Bone-forming osteoporosis drugs increase bone mass, restore bone microarchitecture, and reduce fracture risk more effectively than oral bisphosphonates, providing strong justification for the use of these agents as the initial therapy or after anti-remodeling agents in patients at very high risk of fracture. At the end of a 12-to-24-month course of osteoanabolic therapy, transitioning to a potent anti-remodeling agent maintains and enhances the treatment benefit. This review describes the clinical applications of osteoanabolic therapy for osteoporosis.

KEYWORDS:

• Osteoporosis
• osteoanabolic
• abaloparatide
• romosozumab
• teriparatide
• sequence

Acknowledgements

None stated.

Disclosure statement

Michael R. McClung receives consulting fees for Advisory Boards and honorarium for speaking from Amgen. Micol S. Rothman has received consulting fees from AbbVie Pharmaceuticals. E. Michael Lewiecki has received institutional research grant support from Radius, Amgen, Mereo and Bindex; consulting fees for advisory Boards from Amgen, Radius, Alexion, Sandoz and Samsung Bioepis; and honorarium for speaking from Radius and Alexion; and royalties from UpToDate. David A. Hanley has received institutional research grant support and honorarium for speaking from Amgen and Eli Lilly. Steven T. Harris has received honorarium for speaking from Amgen, Eli Lilly and Radius Health and consulting fees for Advisory Boards of Amgen and Radius Health. Paul D. Miller has received institutional research grant support from Amgen, Radius Health, Regeneron, Ultragenyx, National Bone Health Alliance, Immunodiagnostics, and Roche Diagnostics; he has received consulting fees for Advisory Boards of Amgen, Radius Health, Ultragenyx, National Bone Health Alliance and Sandoz. David L. Kendler has received institutional research grant support and honorarium for speaking from Amgen, Pfizer, AstraZeneca Radius Health and Eli Lilly. The authors have no other relevant conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The Western Osteoporosis Alliance received an unrestricted grant from Radius Health to support this project. The sponsors of this project had no role in any aspect of preparing this review.