Side effects of drugs for osteoporosis and metastatic bone disease

Abstract

Osteoporosis is a common condition that leads to substantial morbidity and mortality and affects an increasing number of persons worldwide. Several pharmacological therapies that inhibit bone resorption, promote bone formation, or both, are available for the treatment of osteoporosis. The osteoanabolic treatment spectrum was recently expanded by the introduction of a novel bone-forming agent in the United States, and clinical trials indicate that a new class of bone anabolic therapy may become available. Both antiresorptive and bone anabolic therapies are associated with common and rare adverse effects, which are particularly important to address as these drugs are used for long-term treatment in numerous patients with a large proportion being elderly and/or having multimorbidity. In addition, antiresorptive drugs are used to inhibit bone resorption in patients with malignant hypercalcaemia or to prevent skeletal events in cancer patients, and bisphosphonates have been repurposed as a cancer preventive therapy. However, therapeutic doses are generally higher when antiresorptive drugs are used in the oncological setting, which influence the prevalence of adverse effects significantly. This review highlights key issues and controversies regarding adverse effects of currently available and emerging drugs used for osteoporosis and metastatic bone diseases.

D-mannose attenuates bone loss in mice via Treg cell proliferation and gut microbiota-dependent anti-inflammatory effects

“…Also, the proportion of CD4 + CD25 + FOXP3 + cells (Treg cells)/CD4 + T cells markedly increased in the OVX group compared with the Sham group after administering D-mannose for 2 weeks and 2 months [p < 0.05; Figure 4 scores showed significantly different microbiota compositions among the six groups. There were 5,18,15,11,12, and 13 in the Sham, Sham-Man, OVX, OVX-Man, s-CTRL, and s-Man group when the LDA scores were >3.6. In the Sham group, there were relatively higher proportions of Clostridium, Clostridiaceae, Rikenellaceae, and Ruminococcaceae.…”

Oleuropein and its peracetylated derivative negatively regulate osteoclastogenesis by controlling the expression of genes involved in osteoclast differentiation and function

“…Antiresorptive medication is often associated with many safety concerns. 6 Owing to these limitations, natural products, mainly phytochemicals are becoming an important research field to explore new therapeutic choices for bone diseases. Oleuropein (OL) is a secoiridoid glycoside that typically represents the most prominent hydrophilic phenolic compound in olives and olive leaves.…”

Cannabinoid receptors in osteoporosis and osteoporotic pain: a narrative update of review

“…As one common disorder in the ageing era, particularly for menopausal women, osteoporosis is a worldwide disease caused by the reduction of bone mineral density (BMD) and alteration of bone architecture which results in the increase of bone fragility and fracture risk. Because of the complicated causes of osteoporosis such as age, sex, postmenopausal status, rheumatoid arthritis, vitamin D deficiency, low calcium intake, hyperkyphosis, alcohol abuse and long‐term of certain therapies, etc, the management of osteoporosis is still a headache problem, and controversial effects are encountered although there are a variety of advancements …”

“…Because of the complicated causes of osteoporosis such as age, sex, postmenopausal status, rheumatoid arthritis, vitamin D deficiency, low calcium intake, hyperkyphosis, alcohol abuse and long-term of certain therapies, etc, the management of osteoporosis is still a headache problem, and controversial effects are encountered although there are a variety of advancements. [1,2] Because osteoporosis is a systemic disorder affecting all bones of the body, it has different demonstrations in clinic. Amongst, osteoporotic pain is the most prevalent morbidity and greatly affects the life quality of patients.…”