Newer therapies in osteoporosis

Osteoporotic fractures are an important public health problem leading to substantial mortality and morbidity in the ageing population. The estimated Indian population, who would be affected by osteoporosis by 2015, would be 25 million. This would be associated with enormous costs and considerable consumption of health resources. Hence prevention and treatment of osteoporosis is of paramount importance. The existing drugs for treatment of osteoporosis are limited in scope, tolerability and antifracture efficacy. Considerable efforts have been made to optimize the existing drugs and to develop newer ones. Long acting bisphosphonates, SERMs with less non-skeletal adverse effects and PTH are definitely milestone developments. Newer osteoclast targeted agents like inhibitors of RANK pathway; cathepsin K; c-src kinase; and integrins are under clinical development. Osteoblast targeted therapies include the agents acting through the Wnt-beta catenin signaling pathway like sclerostin antagonists and Dkk-1 inhibitors. The molecular targets and the emerging drugs for treatment of osteoporosis are discussed.