The Current Status of Sequential Therapy with Commonly Used Anti-Osteoporosis Drugs

Abstract

As the trend of population aging intensifies, the incidence of osteoporosis is rising correspondingly. Osteoporotic fractures are one of the primary causes of disability and death in elderly patients, placing a great burden on both families and society in terms of medical care resources. The monotherapy of osteoporosis drugs has certain limitations and sequential drug treatment should be considered under the following circumstances: (i) when bone resorption inhibitors fail to work, have been used for too long, or cause adverse reactions; (ii) when the recommended treatment course of bone formation promoters (such as parathyroid hormone analogues) has ended but the patient's fracture risk remains high and requires continued treatment; (iii) when short-acting drugs such as teriparatide or denosumab need to maintain treatment effects after discontinuation. The sequential therapy of osteoporosis drugs can be categorized according to the mechanism of action into the following schemes: (i) bone formation promoters followed by bone resorption inhibitors; (ii) bone resorption inhibitors followed by bone formation promoters; (iii) different types of bone resorption inhibitors used sequentially; (iv) other sequential drug treatments. Osteoporosis is a progressive disease, and the ageing of the human population cannot be reversed. Therefore, single-drug treatment is unlikely to achieve the goal of long-term disease prevention and control, making the exploration of long-term treatment plans for existing drugs a key aspect of osteoporosis drug treatment.