Treatment of Osteoporosis: Current Scenario from a Research Perspective

Abstract

Osteoporosis is a condition of compromised bone quality and bone density increasing the chances of fracture. In osteoporotic bone, there is a mismatch between bone formation and resorption. The high probability in both women (33.33%) and males (20%) over the age of 50 worldwide to suffer a fracture draws attention to the importance of treatment of osteoporosis. The benefits of using bisphosphonates, the first line of therapy in osteoporosis lasts for 5 years. The other drugs are recommended for a still shorter time. The state of usage of current drugs is discussed. Two drugs Abaloparatide and Romosozumab have been recently approved. There is a better understanding of the means of communication amongst the different players in bone remodeling. These players involved in remodeling, are subjected to local and systemic influences. This increased understanding of physiology led to molecules being investigated which acts on newer targets such as Cathepsin K, ɑ v β 3 integrin, chloride channel 7, tryptophan hydroxylase 1, Src, calcium-sensing receptor. Also, a bone anabolic effect for certain drugs belonging to different therapeutic classes such as statins, nitrates, thiazides, beta-blockers has been noted. However, for these drugs, further studies regarding the dose and frequency of drug administration and the effectiveness in the prevention of fractures along with safety profiles are needed. The drugs acting on new targets and new uses of old drugs hold hope to increase our arsenal against osteoporosis and thus preventing the mortality and debility due to fractures.

Phytochemical Analysis, Antioxidant and Bone Anabolic Effects of Blainvillea acmella (L.) Philipson

“…Clodronate is the earliest group of non-nitrogen bisphosphonates that have been widely used in the clinical treatment for bone-related diseases by enhancing bone inhibition ( Koch et al, 2011 ; Frediani and Bertoldi, 2015 ; Nardi et al, 2016 ; Pherwani and Sathaye, 2020 ). Bisphosphonates reacted with osteoblast cells and altered bone metabolism by stimulating bone formation ( Corrado et al, 2017 ).…”

“…Current treatments such as calcitonin, estrogen, and bisphosphonates are anti-bone resorptive drugs that inhibit osteoclast activity ( Yang et al, 2018 ). However, long-term use of these treatments is associated with several side effects, such as cancer, femur fractures, osteonecrosis of the jaw, myocardial infarction, thromboembolic events, and skin reaction (DRESS syndrome) ( Khosla and Hofbauer, 2017 ; Pherwani and Sathaye, 2020 ).…”

The Beneficial Effect of Boswellic Acid on Bone Metabolism and Possible Mechanisms of Action in Experimental Osteoporosis

“…The treatment of osteoporosis typically promotes osteoblasts differentiation, which subsequently results in bone formation [ 16 ]. A review of literature signifies that inhibition of NF-κB expression leads to a decline in RANKL expression, resulting in osteoblast differentiation and consequently reducing bone loss [ 17 , 18 ].…”

“…Boswellic acid has been reported to produce anti-inflammatory, antiarthritic, antirheumatic, antidiarrheal, antihyperlipidemic, antiasthmatic, anticancer, antibacterial, antifungal, anticomplementary, and analgesic activity [10,[12][13][14][15]. The treatment of osteoporosis typically promotes osteoblasts differentiation, which subsequently results in bone formation [16]. A review of literature signifies that inhibition of NF-κB expression leads to a decline in RANKL expression, resulting in osteoblast differentiation and consequently reducing bone loss [17,18].…”

“…Further, in vitro and in vivo data demonstrated that AKBA inhibits osteoclastogenesis by hindering NF-κB and NF-κB-regulated gene expression [22] and has a positive impact in the prevention as well as treatment of periprosthetic osteolysis [23]. Therefore, the objective of our study was to assess the The treatment of osteoporosis typically promotes osteoblasts differentiation, which subsequently results in bone formation [16]. A review of literature signifies that inhibition of NF-κB expression leads to a decline in RANKL expression, resulting in osteoblast differentiation and consequently reducing bone loss [17,18].…”