New horizons in treatment of osteoporosis.

Existing Reviews

Please note, new claims can take a short while to show up.

No claims yet.

Annotation Summary

Term Occurence Count Dictionary
Denosumab 8 endocrinologydiseasesdrugs
Teriparatide 9 endocrinologydiseasesdrugs
raloxifene 9 endocrinologydiseasesdrugs
obesity 1 endocrinologydiseases
strontium ranelate 3 endocrinologydiseasesdrugs
osteoporosis 99 endocrinologydiseases
testosterone 2 endocrinologydiseasesdrugs
type 2 diabetes mellitus 1 endocrinologydiseases
calcitriol 2 endocrinologydiseasesdrugs
diabetes mellitus 2 endocrinologydiseases
hypocalcaemia 3 endocrinologydiseases
hypogonadism 1 endocrinologydiseases
zoledronic acid 5 endocrinologydiseasesdrugs
Insulin 1 endocrinologydiseasesdrugs
hypercalcemia 1 endocrinologydiseases
hyperparathyroidism 2 endocrinologydiseases

Graph of close proximity drug and disease terms (within 200 characters).

Note: If this graph is empty, then there are no terms that meet the proximity constraint.

Review

Having read the paper, please pick a pair of statements from the paper to indicate that a drug and disease are related.

Select Drug Character Offset Drug Term Instance
Denosumab 12526 Ibandronate, Zoledronic acid, Clodronate, Minodronate, Pamidronate, Etidronate, TiludronateRANKL antibody Denosumab Estrogen replacementEstrogen conjugateSERMsRaloxifene, Tamoxifene, Lasofoxifene, Bazedoxifene, ArzoxifeneCalcitoninCalcitoninCathepsin
Denosumab 15890 (including hip 40%)[[37], [38]]ClodronatePO/IM/IVLS 3.7%, hip 1.3%Vertebral 43%, non-vertebral 33%[[22]] Denosumab SCLS 9.2-18.4%, hip 4-8.3%Vertebral 68%, hip 40%, non-vertebral 20%[[45], [46]]Estrogen Replacement (ERT,
Denosumab 17914 +TeriparatideIV/SCLS 7.5% vs. 7.0% by PTH/ 4.4% by BPs, total hip 2.3% vs. 1.1% by PTH / 2.2% by BPsNA[[93]] Denosumab +TeriparatideSC/SCLS 9.1% vs. 6.2% by PTH/ 5.5% by denosumab, total hip 4.9% vs. 0.7% by PTH/ 2.5% by
Denosumab 24441 time, based on risk-benefit ratio for using BPs especially reduction of the fracture risk [[23], [35]]. Denosumab Denosumab (Prolia®) is a human monoclonal RANKL antibody that results in osteoclast inactivation, apoptosis,
Denosumab 24450 on risk-benefit ratio for using BPs especially reduction of the fracture risk [[23], [35]].Denosumab Denosumab (Prolia®) is a human monoclonal RANKL antibody that results in osteoclast inactivation, apoptosis,
Denosumab 25051 who are intolerant to oral BPs or have renal failure [[46]]. The “Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months” (FREEDOM) trial showed the efficacy of denosumab on fracture-risk
Denosumab 26830 patients should be informed to use appropriate drugs if develop signs of infection or skin reaction. Denosumab was not only well tolerated in osteoporosis clinical trials, but also no account of jaw osteonecrosis,
Denosumab 55070 osteoporosis in men. Zoledronic acid is a suitable alternative in patients who do not tolerate oral BPs. Denosumab is a good choice in osteoporotic men who are intolerant to other drugs or have renal failure. BPs therapy
Insulin 8264 OCs: osteoclasts; Wnt: wingless and Int proteins; LRP5/6: LDL-receptor related protein 5/6; IGF-1: Insulin like growth factor-1; L-C: L-carnitine; OBs: osteoblastsBone remodeling requires the activities of both
Teriparatide 12817 ONO-5334Strontium ranelateStrontiumPharmacological agents (anabolic drugs)PTH peptidesAnti-sclerostin antibodies Teriparatide , PTH 1-84Romosozumb, Blosozumab, BPS804Legend: BPs Bisphosphonates, SERMs selective estrogen receptor
Teriparatide 16774 non-vertebral[[67], [68]]CalcitoninNasal spray/SC/IMLS 1-1.5%Vertebral 60%[[55]]Anabolic agentsPTH peptides Teriparatide SCSpine 8.6-13%, FN 3.5-6%Vertebral 65-69%, non-vertebral 53%[[6], [55], [72], [73]]PTH 1-84SCLS 6.9%,
Teriparatide 17571 2.1-6.3%, FN 2.7-6.3%NA[[85]]Combination therapyAntiresorptive and anabolic agentsBPs + PTHAlendronate + Teriparatide PO/SCLS 14.8% vs. 18.1% by PTH/ 7.9% by BPs, total hip without differencesNA[[73]]Risedronate +TeriparatidePO/SCTotal
Teriparatide 17678 TeriparatidePO/SCLS 14.8% vs. 18.1% by PTH/ 7.9% by BPs, total hip without differencesNA[[73]]Risedronate + Teriparatide PO/SCTotal hip 3.9% vs. 0.3% by PTH/ 0.8% by BPs, FN 8.4% vs. 3.9% by PTH/ 0.5% by BPsNA[[73], [93]]Zoledronic
Teriparatide 17807 3.9% vs. 0.3% by PTH/ 0.8% by BPs, FN 8.4% vs. 3.9% by PTH/ 0.5% by BPsNA[[73], [93]]Zoledronic acid + Teriparatide IV/SCLS 7.5% vs. 7.0% by PTH/ 4.4% by BPs, total hip 2.3% vs. 1.1% by PTH / 2.2% by BPsNA[[93]]Denosumab
Teriparatide 17925 +TeriparatideIV/SCLS 7.5% vs. 7.0% by PTH/ 4.4% by BPs, total hip 2.3% vs. 1.1% by PTH / 2.2% by BPsNA[[93]]Denosumab + Teriparatide SC/SCLS 9.1% vs. 6.2% by PTH/ 5.5% by denosumab, total hip 4.9% vs. 0.7% by PTH/ 2.5% by denosumab, FN
Teriparatide 18094 hip 4.9% vs. 0.7% by PTH/ 2.5% by denosumab, FN 4.2% vs. 0.8% by PTH/ 2.1% by denosumabNA[[94]]SERMs+ Teriparatide Raloxifene +TeriparatidePO/SCLS 6.2% vs. 5.2% by PTH, total hip 2.3% vs. 0.8% by PTH, FN 2.2% vs. 1.0%
Teriparatide 18118 2.5% by denosumab, FN 4.2% vs. 0.8% by PTH/ 2.1% by denosumabNA[[94]]SERMs+ TeriparatideRaloxifene + Teriparatide PO/SCLS 6.2% vs. 5.2% by PTH, total hip 2.3% vs. 0.8% by PTH, FN 2.2% vs. 1.0% by PTHNA[[57]]AntiresorptivesBPs+
Teriparatide 36643 the nasal spray compared with in those who took placebo [[70]].Approved FDA/Europe anabolic agentsPTH Teriparatide (recombinant human parathyroid 1-34) (Forteo®) and intact molecule (amino acids 1-84) are peptides
calcitriol 12996 Bisphosphonates, SERMs selective estrogen receptor modulatorCalcium and vitamin D supplementationIn some countries calcitriol and alfa-calcidol have been used as synthetic analogues of vitamin D for the treatment of osteoporosis.
calcitriol 13366 risk reduction at vertebral and non-vertebral sites [[25], [26]]. However, the beneficial effect of calcitriol was reported for prevention of bone loss in osteoporosis after glucocorticoid therapy or after transplantation
raloxifene 18560 2.7% vs. 1.8% by HRTNA[[35]]BPs+ SERMsAlendronate +RaloxifenePO/POLS 5.3% vs. 4.3% by BPs/ 2.1% by raloxifene , FN 3.7% vs. 2.7% by BPs/ 1.7% by raloxifene,NA[[57], [95]]Legend: BPs Bisphosphonates, FDA Food and
raloxifene 18605 SERMsAlendronate +RaloxifenePO/POLS 5.3% vs. 4.3% by BPs/ 2.1% by raloxifene, FN 3.7% vs. 2.7% by BPs/ 1.7% by raloxifene ,NA[[57], [95]]Legend: BPs Bisphosphonates, FDA Food and Drug Administration, EU Europe, PO oral route,
raloxifene 29325 cardiovascular system without any adverse effects of estrogen on breast and endometrium. This group includes raloxifene (Evsita®), tamoxifene (Soltamox®), lasofoxifene (Fablyn®), and bazedoxifene (Viviant®, Conbriza®).Raloxifene
raloxifene 29791 without any significant effect on non-vertebral fracture risk [[57]–[59]]. The safety and efficacy of raloxifene on BMD can be extended for eight years according to clinical trials. Although some clinicians are continuing
raloxifene 30076 after stopping usage [[57]]. Due to reduction of BMD and enhancement of bone turnover associated with raloxifene in premenopausal women, it is not recommended in this population. Raloxifene can decrease the risk of
raloxifene 30535 the least adverse effects.Bazedoxifene that is available in Europe and Japan have similar effects to raloxifene in osteoporosis [[60], [61]] but its long term safety or its impact on the risk of breast cancer is
raloxifene 33051 0.25 mg/daily [[67]]. It is approved by Europe but not approved by FDA.Arzoxifene (LY353381) as a long acting raloxifene and ospemifene (Ophena®) that is structurally tamoxifene-like are new versions of SERMs with beneficial
raloxifene 33410 studies with ospemifene and arzoxifene are proceeding that are not approved by FDA, yet.Generally, BPs or raloxifene are suggested as first-line choices for prevention of osteoporosis in postmenopausal women, pointing
raloxifene 52086 suppression of bone turnover and enhancement of fracture risk [[95], [96]]. Alendronate plus estrogen or raloxifene increased BMD to a greater extent when compared to either drug alone, in addition to unknown benefit
strontium ranelate 1585 potential adverse events on long time usage. Development of newer agents such as cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis, but also have opened doors
strontium ranelate 40633 of newer agents. Currently progression in development of newer agents such as cathepsin k inhibitor, strontium ranelate , AMG785, and AMG167 not only have increased the available options for treating osteoporosis, but also
strontium ranelate 45074 Human Use (CHMP) recommended a restriction in the use of the osteoporosis medicine Protelos/ Osseor ( strontium ranelate ), following an assessment of data showing an increased risk of serious heart attack, with no observed
testosterone 54074 pharmacological or hormonal therapy. Because the most common cause of osteoporosis in men is hypogonadism, testosterone replacement therapy can increase BMD by 5% in spine. Data of clinical trials confirms the beneficial
testosterone 54198 therapy can increase BMD by 5% in spine. Data of clinical trials confirms the beneficial effect of testosterone on BMD for at least 2 years [[99]]. Androgens have beneficial effects on cardiovascular system and
zoledronic acid 19413 Drugs of this group include alendronate (Fosamax®), risendronate (Actonel®), ibandronate (Boniva®), zoledronic acid (Reclast®), clodronate (Bonefos®, Clasteon®), minodronate (Onobis®), pamidronate (Aredia®), etidronate
zoledronic acid 20424 bones [[32]].However, an increase in spine BMD rather than decrease in fracture risk was shown for zoledronic acid [[33]]. Clodronate is a weak BPs with beneficial effects on spine and hip BMD as well as vertebral and
zoledronic acid 20815 different BPs including alendronate, clodronate, ibandronate, minodronate, pamidronate, risedronate, zoledronic acid , etidronate, and tiludronate in prevention of fractures in primary osteoporosis. The most effective
zoledronic acid 20982 fractures in primary osteoporosis. The most effective BPs in the prevention of fracture at any sites was zoledronic acid , but alendronate or zoledronic acid revealed the highest effectiveness solely in preventing hip fracture
zoledronic acid 21018 most effective BPs in the prevention of fracture at any sites was zoledronic acid, but alendronate or zoledronic acid revealed the highest effectiveness solely in preventing hip fracture [[34]]. Overall, the choice of
Select Disease Character Offset Disease Term Instance
diabetes mellitus 9781 association not only between bone and insulin sensitivity, but also between osteoporosis and obesity or diabetes mellitus has been reported [[16], [17]].The key role of oxidative stress, epigenetic, and gut microbiota in the
diabetes mellitus 47399 colitis, rheumatoid arthritis, osteoarthritis, osteogenesis imperfecta, and bone complications of type 2 diabetes mellitus [[88]]. The most frequently reported adverse effects are elevated liver enzymes after first dose that
hypercalcemia 39045 teriparatide [[22]]. Its use is contraindicated in patients with Paget, past bone irradiation therapy, hypercalcemia , hyperparathyroidism, bone metastasis, unexplained high level of alkaline phosphatase, and severe renal
hyperparathyroidism 4017 to accelerated bone turnover secondary to estrogen deficiency. However, vitamin D insufficiency and hyperparathyroidism remain as the main causes of osteoporosis in men and premenopausal women. By 2050, the worldwide incidence
hyperparathyroidism 39060 [[22]]. Its use is contraindicated in patients with Paget, past bone irradiation therapy, hypercalcemia, hyperparathyroidism , bone metastasis, unexplained high level of alkaline phosphatase, and severe renal failure. It should
hypocalcaemia 25665 Its combination with other pharmacological agents for osteoporosis is not suggested. Similar to BPs, hypocalcaemia and vitamin D deficiency should be managed before starting treatment, and adequate Ca and vitamin D
hypocalcaemia 26982 osteoporosis clinical trials, but also no account of jaw osteonecrosis, arterial fibrillation, and symptomatic hypocalcaemia is reported, yet. Of the most commonly reported adverse effects were musculoskeletal pain, hypercholesterolemia,
hypocalcaemia 35630 (more than 3 months). The adverse effects include nausea, vomiting, flushing, allergic reactions, hypocalcaemia , nasal adverse reactions, calcitonin’ antibodies formation, and prostate cancer. In required situations,
hypogonadism 54060 addition to pharmacological or hormonal therapy. Because the most common cause of osteoporosis in men is hypogonadism , testosterone replacement therapy can increase BMD by 5% in spine. Data of clinical trials confirms
obesity 9770 close association not only between bone and insulin sensitivity, but also between osteoporosis and obesity or diabetes mellitus has been reported [[16], [17]].The key role of oxidative stress, epigenetic, and
osteoporosis 75 Title: DARU Journal of Pharmaceutical SciencesNew horizons in treatment of osteoporosis Ozra Tabatabaei-MalazyPooneh SalariPatricia KhashayarBagher LarijaniPublication date (epub): 2/2017Publication
osteoporosis 292 2/2017Publication date (pmc-release): 2/2017Publication date (collection): /2017AbstractBackgroundPrevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost
osteoporosis 409 increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis , worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment.
osteoporosis 602 main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis , there still remains a need to more specific drugs with less adverse effects.Main bodyThis review article
osteoporosis 918 by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation
osteoporosis 1303 conclusionThe use of current antiresorptive and anabolic agents alone or in combinations for the treatment of osteoporosis entails several limitations. Mainly, their efficacy on non-vertebral fracture reduction is lower than
osteoporosis 1663 cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis , but also have opened doors of opportunity to improvements in the effective treatment. However, the
osteoporosis 2138 also for environmental exposure assessment. In addition to permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there
osteoporosis 2195 permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there seems a need to more well-designed clinical trials with
osteoporosis 2610 trials with combination of two or more synthetic drugs, plants, or drug-plant for the treatment of osteoporosis are recommended.Graphical AbstractSummary of treatment modalities for osteoporosis.BackgroundOsteoporosis
osteoporosis 2693 the treatment of osteoporosis are recommended.Graphical AbstractSummary of treatment modalities for osteoporosis .BackgroundOsteoporosis is one of the common health problems with a progressive prevalence both in developed
osteoporosis 3446 with an accident of osteoporotic fracture every 3 seconds [[1]]. Both primary and secondary types of osteoporosis are associated with reduction in bone mass and microarchitecture that result in bone fragility with
osteoporosis 3684 disability, morbidity, and fracture risk [[5]]. Thus, access to diagnosis and adequate therapy for osteoporosis is a main challenge worldwide.Osteoporosis is more prevalent in women than men; 34% versus 17%, respectively.
osteoporosis 3816 worldwide.Osteoporosis is more prevalent in women than men; 34% versus 17%, respectively. Usually, osteoporosis is prevalent in postmenopausal women and is presented as fractures in hip and spine due to accelerated
osteoporosis 4066 estrogen deficiency. However, vitamin D insufficiency and hyperparathyroidism remain as the main causes of osteoporosis in men and premenopausal women. By 2050, the worldwide incidence of hip fracture is expected to rise
osteoporosis 4775 cerebrovascular accident, and breast cancer in 2011 [[8]].A systematic review showed that the costs of osteoporosis treatment were not only greater than pre-fracture costs (as 1.6-6.2 times), but also were more than
osteoporosis 4995 spent for matched controls (2.2-3.5 times) [[9]].Thus, due to the rapid growth in burden and cost of osteoporosis worldwide, it will be reasonable to focus on reduction of fractures as the main goal of treatment. WHO
osteoporosis 5437 it is important to have a more accurate and comprehensive look on the pharmacologic therapies of the osteoporosis .This review article provides an update on the most current pharmacological products approved by Europe
osteoporosis 5607 current pharmacological products approved by Europe or the US Food and Drug Administration (FDA) to treat osteoporosis according to available data at PubMed, UpToDate, IOF, and clinical practice guidelines.PathogenesisBone
osteoporosis 5978 bone resorption and deposition tips toward excessive resorption, bone loss occurs as a forerunner of osteoporosis [[11]].Osteoporosis is a multifactorial disease which has a complex pathophysiology potentially caused
osteoporosis 7176 (ERα) and estrogen receptor β (ERβ). Estrogen deficiency has a critical role in the pathogenesis of osteoporosis due to its association with increased bone resorption, and impaired bone formation [[13]].Bone micro-damages
osteoporosis 7846 RANKL and down-regulation of OPG expression [[12]].Fig. 1A brief schematic view of pathophysiology of osteoporosis and influence of some drugs on bone health. Legend: PTH: parathyroid hormone; PGE2: prostaglandin E2;
osteoporosis 9753 adipogenesis. Also, a close association not only between bone and insulin sensitivity, but also between osteoporosis and obesity or diabetes mellitus has been reported [[16], [17]].The key role of oxidative stress, epigenetic,
osteoporosis 9918 [[16], [17]].The key role of oxidative stress, epigenetic, and gut microbiota in the pathogenesis of osteoporosis is established, too. Oxidative stress is an imbalance between the production of reactive oxygen species
osteoporosis 11022 serotonin precursor, as well as suppression of osteoclastogenesis is improved [[21]].Management of osteoporosis Pharmacological agents are used as the typical treatment of osteoporosis. However, lifestyle modifications
osteoporosis 11094 improved [[21]].Management of osteoporosisPharmacological agents are used as the typical treatment of osteoporosis . However, lifestyle modifications through receiving adequate nutritional supplements (including calcium
osteoporosis 11786 vertebroplasty and kyphoplasty have been used for pain relief. It is notable that the main adverse effect of osteoporosis is the increasing risk of vertebral fracture. Due to limitations in published studies assessing the
osteoporosis 11928 vertebral fracture. Due to limitations in published studies assessing the role of these procedures for osteoporosis , their benefits have still remained uncertain [[22], [23]]. Summary of recommended lifestyle modifications
osteoporosis 12079 uncertain [[22], [23]]. Summary of recommended lifestyle modifications and pharmacological agents for osteoporosis are shown in Table 1.Table 1Summary of treatment modalities for osteoporosisTreatment modalitiesDrug
osteoporosis 12157 pharmacological agents for osteoporosis are shown in Table 1.Table 1Summary of treatment modalities for osteoporosis Treatment modalitiesDrug classMedicationsLifestyle modificationsNutritional supplementsPhysical activitySmoking
osteoporosis 13097 calcitriol and alfa-calcidol have been used as synthetic analogues of vitamin D for the treatment of osteoporosis . A meta-analysis showed that vitamin D supplementation alone cannot reduce fracture risk. However, the
osteoporosis 13421 [[25], [26]]. However, the beneficial effect of calcitriol was reported for prevention of bone loss in osteoporosis after glucocorticoid therapy or after transplantation of solid organ or stem cell [[27]]. The main adverse
osteoporosis 14317 respectively, in premenopausal osteoporotic women and men [[31]].Pharmacological agents for treatment of osteoporosis Pharmacological agents are classified into two groups, antiresorptive and anabolic agents. The main mechanism
osteoporosis 14929 beneficial effects on extra-skeleton tissues and organs but by considering the most part of the burden of osteoporosis which is related to fractures especially hip fracture; the current approach to treatment of osteoporosis
osteoporosis 15034 osteoporosis which is related to fractures especially hip fracture; the current approach to treatment of osteoporosis is focused on patient’s BMD and fracture risk. The beneficial effects of the pharmacological agents
osteoporosis 15249 were presented in Table 2.Table 2Summary of characteristics of pharmacological agents for treating osteoporosis in clinical trials’ studiesDrugs classMedicationRoute of administrationEvidences of main effectRef.Increase
osteoporosis 19108 antiresorptive drugsBisphosphonates (BPs)BPs are recommended as the first-line medications for treatment of osteoporosis . Their effects on bone cells are most notable through inactivating osteoclastic bone resorption and
osteoporosis 19785 etidronate and pamidronate are available in the US but not approved for prevention or treatment of osteoporosis [[22]].Alendronate and risendronate are the most commonly used BPs worldwide. Alendronate not only has
osteoporosis 20605 and hip BMD as well as vertebral and non-vertebral fracture risk in clinical trials. Its usage for osteoporosis has been approved in Europe [[22]]. A network meta-analysis compared the short term efficacy of different
osteoporosis 20898 pamidronate, risedronate, zoledronic acid, etidronate, and tiludronate in prevention of fractures in primary osteoporosis . The most effective BPs in the prevention of fracture at any sites was zoledronic acid, but alendronate
osteoporosis 21553 (observational or clinical trial), and their comparison with placebo or other pharmacological treatments of osteoporosis [[1], [22], [34]–[39]]. A summary of the evidence-based data are shown in Table 2.According to the
osteoporosis 21823 (AACE), response to treatment (not only with BPs but also with other pharmacological agents for treating osteoporosis ) can be monitored by serial assessment of BMD (hip and lumbosacral) every one-two years after initiating
osteoporosis 24316 reports of a serious adverse reaction by BPs [[41]], they have remained as the front line treatment for osteoporosis , at this time, based on risk-benefit ratio for using BPs especially reduction of the fracture risk [[23],
osteoporosis 24842 of CTX-1 has been reported [[1]]. Although it is not as the first-line pharmacological treatment of osteoporosis , but can be initiated as a first-line choice for treatment of osteoporosis in certain patients who are
osteoporosis 24917 pharmacological treatment of osteoporosis, but can be initiated as a first-line choice for treatment of osteoporosis in certain patients who are intolerant to oral BPs or have renal failure [[46]]. The “Fracture REduction
osteoporosis 25550 Generally, it is not recommended to be used in premenopausal women or children and for prevention of osteoporosis . Its combination with other pharmacological agents for osteoporosis is not suggested. Similar to BPs,
osteoporosis 25618 children and for prevention of osteoporosis. Its combination with other pharmacological agents for osteoporosis is not suggested. Similar to BPs, hypocalcaemia and vitamin D deficiency should be managed before starting
osteoporosis 26111 Monitoring of response to treatment with BMD is similar to monitoring of other pharmacological agents for osteoporosis that BMD evaluation is recommended 2 years after treatment. Due to the expression of RANK and RANKL
osteoporosis 26871 appropriate drugs if develop signs of infection or skin reaction. Denosumab was not only well tolerated in osteoporosis clinical trials, but also no account of jaw osteonecrosis, arterial fibrillation, and symptomatic hypocalcaemia
osteoporosis 27387 (ERT) or estrogen-progestin (hormone) replacement therapy (HRT) alone is effective for prevention of osteoporosis in postmenopausal women [[50]]. Although the main effect of estrogen on bone health is reducing bone
osteoporosis 28089 example as Boltin® or Tibocina® in Spain and Xyvion® in Australia. Tibolone is used for prevention of osteoporosis and treatment of vasomotor symptoms of menopause. The Long-term Intervention on Fractures with Tibolone
osteoporosis 28795 a short period. Moreover, HRT or ERT are not recommended as the first-line preventive treatment of osteoporosis . Beneficial effects of estrogen therapy on BMD will be decreased as nearly 5% during the first year
osteoporosis 29096 to the adverse effects of estrogen in extra-skeletal organs, SERMs has been considered for treating osteoporosis in both sexes. SERMs contain nonsteroidal synthetic compounds with similar effects of estrogen on bone
osteoporosis 30549 adverse effects.Bazedoxifene that is available in Europe and Japan have similar effects to raloxifene in osteoporosis [[60], [61]] but its long term safety or its impact on the risk of breast cancer is not yet determined.
osteoporosis 30868 bazedoxifene is its combination with conjugated estrogen (Duavee®) that can be used for treatment of osteoporosis and reduction of postmenopausal hot flashes [[62]]. Its common adverse effects are muscle cramps, GI
osteoporosis 32334 bleeding, it should not be considered as the first-line therapeutic option of SERMs class for treating osteoporosis [[57]].Lasofoxifene has shown protective effects on bone unlike its effect on breast and uterine. In
osteoporosis 33475 approved by FDA, yet.Generally, BPs or raloxifene are suggested as first-line choices for prevention of osteoporosis in postmenopausal women, pointing out that BPs are recommended over SERMs for treatment of osteoporosis.
osteoporosis 33579 osteoporosis in postmenopausal women, pointing out that BPs are recommended over SERMs for treatment of osteoporosis . One should consider that the non-skeletal effects of SERMs have important role in selection of patients
osteoporosis 33771 in selection of patients to use them. Raloxifene is contraindicated for prevention or treatment of osteoporosis in premenopausal women. BMD monitoring is required in the population taking tamoxifen [[57]].CalcitoninCalcitonin
osteoporosis 34056 32-amino-acid peptide is secreted by C-cells of the thyroid. It is considered as a second-line therapy for osteoporosis in settings where first-line drugs have failed to response or patients are found intolerable. Calcitonin
osteoporosis 35378 long-term usage, and less availability compared to BPs, calcitonin is typically not used for treating osteoporosis unless to relief acute pain (onset <10 days) secondary to osteoporotic fracture. In contrast, calcitonin
osteoporosis 35935 acute pain of fracture, calcitonin should be quickly switched to other pharmacological treatments of osteoporosis [[69]]. Calcitonin has withdrawn from the market in Europe and Canada. Although it is available in the
osteoporosis 36067 has withdrawn from the market in Europe and Canada. Although it is available in the US for treating osteoporosis , FDA Advisory Committee has not recommended it, yet [[55]]. In 2013, FDA advisory panels have recommended
osteoporosis 36243 2013, FDA advisory panels have recommended that marketing of calcitonin salmon for the treatment of osteoporosis in women greater than 5 years after menopause should be stopped. This is while in 2012, the European
osteoporosis 36442 2012, the European Medicines Agency had recommended that calcitonin salmon should not be used to treat osteoporosis after determining that the risk of developing cancer was 2.4% higher in patients using the nasal spray
osteoporosis 38361 subcutaneous (SC) route of administration, and the availability of other pharmacological agents for treating osteoporosis [[73]]. On the other word, these drugs are suitable for patients at high risk of fracture, severe osteoporosis
osteoporosis 38472 osteoporosis [[73]]. On the other word, these drugs are suitable for patients at high risk of fracture, severe osteoporosis (BMD < -3.0 T score), unsatisfactory response to anti-resorptive agents or unable to tolerate BPs,
osteoporosis 38630 response to anti-resorptive agents or unable to tolerate BPs, and patients with glucocorticoid-induced osteoporosis [[6]]. Its common adverse effects include dizziness, headache, nausea, and leg cramp [[75]]. Osteogenic
osteoporosis 40294 be avoided by taking an antiresorptive agent such as BPs [[55]].New agentsThe main goal of treating osteoporosis is based on marked increase in BMD and fracture free-period. Despite that current medications have effectively
osteoporosis 40731 inhibitor, strontium ranelate, AMG785, and AMG167 not only have increased the available options for treating osteoporosis , but also have opened doors of opportunity to improvements in the effective treatment.Cathepsin k inhibitorCathepsin
osteoporosis 43221 ranelateStrontium ranelate (Protelos®) is an antiresorptive agent approved in Europe for treatment of severe osteoporosis in mobile postmenopausal women at high risk of vertebral and hip fractures who cannot use or tolerate
osteoporosis 43424 or tolerate other pharmacological agents. In addition, it is recommended for use in Europe to treat osteoporosis in men at high risk of fracture. Although its mechanism of action is unclear, modest antiresorptive
osteoporosis 45034 (EMA's) Committee for Medicinal Products for Human Use (CHMP) recommended a restriction in the use of the osteoporosis medicine Protelos/ Osseor (strontium ranelate), following an assessment of data showing an increased
osteoporosis 45294 increase in mortality risk. The CHMP recommended that Protelos should only be used to treat severe osteoporosis in postmenopausal women or in men at high risk of fracture. Additional measures, including restrictions
osteoporosis 48843 carry the therapeutic gene. OPG, BMP and PTH have been reported as the most promising molecules for osteoporosis treatment, but not many new molecules have been studied as possible targets in this regard.Various cytokines
osteoporosis 49122 interleukin-1 receptor antagonist (IL-1Ra) have also shown promising results as new therapeutic agents for osteoporosis in animal models, but their application is hindered by delivery problems. However, there are some barriers
osteoporosis 49268 application is hindered by delivery problems. However, there are some barriers on use of these drugs for osteoporosis treatment that are as following [[90], [91]]:It was shown the calcified matrix of the bone tissue is
osteoporosis 50551 such as inhibitors of bone resorption can be considered as an appropriate strategy for treatment of osteoporosis . However, it should be noticed that the metabolism of a drug is varied individually, and the safety
osteoporosis 51474 hip compared with either therapy alone. Although BPs plus PTH is not recommended for management of osteoporosis , immediate use of BPs after withdrawing teriparatide can increase BMD at lumbosacral. Combinations of
osteoporosis 53275 genetic risk score and individualized environmental exposure may have a key role in pathophysiology of osteoporosis [[98]].Osteoporosis in menDue to the higher prevalence of osteoporosis among women than men, greater
osteoporosis 53346 key role in pathophysiology of osteoporosis [[98]].Osteoporosis in menDue to the higher prevalence of osteoporosis among women than men, greater focus is paid on treatment of osteoporosis in women and several large
osteoporosis 53419 to the higher prevalence of osteoporosis among women than men, greater focus is paid on treatment of osteoporosis in women and several large randomized clinical trials have been conducted on this population. However,
osteoporosis 53709 increased in osteoporotic men than in women. Thus special attention should be paid to the treatment of osteoporosis in men. Similar approach is recommended in treating osteoporosis in both sexes. Osteoporotic men should
osteoporosis 53774 should be paid to the treatment of osteoporosis in men. Similar approach is recommended in treating osteoporosis in both sexes. Osteoporotic men should intake adequate Ca (from 1000 to 1200 mg daily according to
osteoporosis 54037 supplementation in addition to pharmacological or hormonal therapy. Because the most common cause of osteoporosis in men is hypogonadism, testosterone replacement therapy can increase BMD by 5% in spine. Data of clinical
osteoporosis 54430 prostate [[100]]. Androgen replacement therapy beside other pharmacological agents for treatment of osteoporosis is recommended for hypogonadal men at fracture risk [[101]]. Although it is expected that androgen therapy
osteoporosis 54601 [[101]]. Although it is expected that androgen therapy should have beneficial effects in elderly men with osteoporosis , sarcopenia, or falls, a meta-analysis study did not show its beneficial effects on bone health [[102]].Overall,
osteoporosis 54823 [[102]].Overall, all pharmacological agents can be safely considered as a therapeutic option in the treatment of osteoporosis in men [[103]]. Alendronate or risendronate are favorable BPs that are recommended as the first line
osteoporosis 54965 or risendronate are favorable BPs that are recommended as the first line pharmacological therapy for osteoporosis in men. Zoledronic acid is a suitable alternative in patients who do not tolerate oral BPs. Denosumab
osteoporosis 55223 are intolerant to other drugs or have renal failure. BPs therapy should be stopped in men with severe osteoporosis who are intolerant or unresponsive to BPs therapy after one year, and PTH therapy should be selected
osteoporosis 55662 understanding the signaling pathway, but there are also needs to conduct more studies on prevention of osteoporosis , safety and efficacy of anti-osteoporotic pharmacological agents, and drug discovery. It was reported
osteoporosis 55878 in most of the studies that antioxidative mechanism has the main role in prevention and treatment of osteoporosis [[104]–[106]]. Some of these products include green tea, quercetin, curcumin, phytoestrogens, omega-3
osteoporosis 58361 at-risk populations.ConclusionsCurrently, the development of pharmacological agents in treatment of osteoporosis has discovered new agents that effectively reduce fracture risk. Due to the lack of appropriate clinical
osteoporosis 59000 dosing requirement.Some limitations exist despite the major advances in drug discovery for treatment of osteoporosis . First, their efficacy on hip fracture reduction is lower than what observed on lumbosacral fracture.
osteoporosis 59853 drug safety and efficacy. On the other hand, the progressive advances in the personalized therapy for osteoporosis raises the necessity for identifying the main genes and signaling pathways involved in bone loss of
osteoporosis 60288 for environmental exposure assessment.In addition to continuous attention to the early diagnosis of osteoporosis , more well-designed clinical trials is required on the safety and efficacy of current available anti-osteoporosis
osteoporosis 60402 more well-designed clinical trials is required on the safety and efficacy of current available anti- osteoporosis agents. As well, continuous preclinical assessment of newer agents, conduction of clinical trials, searching
osteoporosis 60610 trials, searching for novel approach in drug discovery based on understanding of the pathophysiology of osteoporosis are strictly recommend. The authors also suggest conducting future research on plant-derived components
osteoporosis 60887 clinical trials with combination of two or more synthetic drugs, plants, or drug-plant for treatment of osteoporosis as the solutions
type 2 diabetes mellitus 47392 as colitis, rheumatoid arthritis, osteoarthritis, osteogenesis imperfecta, and bone complications of type 2 diabetes mellitus [[88]]. The most frequently reported adverse effects are elevated liver enzymes after first dose that

You must be authorized to submit a review.