Abstract
Currently available drugs in postmenopausal osteoporosis have proven efficacy, based on randomized clinical trials with very high levels of evidence. Decreasing the rates of incident fractures was the primary endpoint in these trials. Antiosteoporotic drugs have distinct mechanisms of action towards bone resorption and bone formation. They are also distinguishable through distinct effects on the various osteoporotic events, that is vertebral, peripheral, and femoral fractures. Only bisphosphonates and strontium ranelate have demonstrated efficacy for all these types of fractures. Furthermore, strontium ranelate is the only agent able to inhibit bone resorption while stimulating bone formation. Further therapeutic advances are expected to occur within years, including the release of biological modulators of osteoclasts and osteoblasts, and the construction of innovative strategies for the optimal use of available drugs.
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