Therapeutic advances in the treatment of osteoporosis

Until recently, pharmacological options for the treatment of osteoporosis have been limited to antiresorptive agents, including the oral bisphosphonates. Evidence from randomized controlled trials and meta-analyses support the efficacy and safety of oral bisphosphonates as first-line pharmacologic agents in the prevention and treatment of osteoporosis. However, advances in parenteral bisphosphonate therapy, the development of antireceptor activator of NF-κB ligand (anti-RANKL) therapy, the development of anabolic agents, namely parathyroid hormone and related peptides, as well as the emergence of strontium ranelate as a novel therapeutic agent with both anabolic and antiresporptive properties, have dramatically expanded our pharmacologic armamentarium of antiosteoporosis treatments. Effective treatment options now exist for patients in whom older agents were either contraindicated or not tolerated. This review will focus on recent developments in osteoporosis treatments in advanced phases of development.