Abstract
Osteoporosis represents the most common bone disease worldwide and results in a significantly increased fracture risk. Extrinsic and intrinsic factors implicated in the development of osteoporosis are also associated with delayed fracture healing and impaired bone regeneration. Based on a steadily increasing life expectancy in modern societies, the global implications of osteoporosis and impaired bone healing are substantial. Research in the last decades has revealed several molecular pathways that stimulate bone formation and could be targeted to treat both osteoporosis and impaired fracture healing. The identification and development of therapeutic approaches modulating bone formation, rather than bone resorption, fulfils an essential clinical need, as treatment options for reversing bone loss and promoting bone regeneration are limited. This review focuses on currently available and future approaches that may have the potential to achieve these aims.
Highlights
Osteoporosis represents a polygenetic, environmentally modifiable bone disease, which often results in fragility fractures and poses a high risk of fractures in low impact trauma
A range of drugs approved by the United States Federal Drug Administration (FDA), which work by inhibiting bone resorption, are available for the prevention and treatment of osteoporosis
As bone formation is coupled to bone resorption, inhibition of bone resorption is followed by a decrease in osteoblast activity
Summary
Osteoporosis represents a polygenetic, environmentally modifiable bone disease, which often results in fragility fractures and poses a high risk of fractures in low impact trauma. The molecular perturbations leading to osteoporosis are associated with delayed fracture healing and impaired bone regeneration. A range of drugs approved by the United States Federal Drug Administration (FDA), which work by inhibiting bone resorption, are available for the prevention and treatment of osteoporosis. These substances including bisphosphonates, the monoclonal antibody denosumab and selective oestrogen receptor modulators, only inhibit the breakdown of bone but do not stimulate the formation of new bone. Research in the last decades has revealed several pathways that stimulate bone formation and could be applied to treat both osteoporosis and impaired fracture healing. This review focuses on currently available and future approaches that may be employed to target bone formation and bone regeneration in every day clinical practice
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