Medical Treatment for Osteoporosis: From Molecular to Clinical Opinions

Int J Mol Sci. 2019 May 6;20(9):2213. doi: 10.3390/ijms20092213.

Abstract

Osteoporosis is a major concern all over the world. With aging, a gradual loss of bone mass results in osteopenia and osteoporosis. Heritable factors account for 60-80% of optimal bone mineralization. Modifiable factors, such as weight-bearing exercise, nutrition, body mass, and hormonal milieu, play an important role in the development of osteopenia and osteoporosis in adulthood. Currently, anti-resorptive agents, including estrogen, bisphosphonates, and selective estrogen receptor modulators (SERMs), are the drugs of choice for osteoporosis. Other treatments include parathyroid hormone (PTH) as well as the nutritional support of calcium and vitamin D. New treatments such as tissue-selective estrogen receptor complexes (TSECs) are currently in use too. This review, which is based on a systematic appraisal of the current literature, provides current molecular and genetic opinions on osteoporosis and its medical treatment. It offers evidence-based information to help researchers and clinicians with osteoporosis assessment. However, many issues regarding osteoporosis and its treatment remain unknown or controversial and warrant future investigation.

Keywords: anti-resorptive drugs; genetics; molecular pathway; osteoporosis.

Publication types

  • Review

MeSH terms

  • Animals
  • Bone Density / drug effects
  • Bone Density / genetics
  • Bone Density Conservation Agents / pharmacology
  • Bone Density Conservation Agents / therapeutic use*
  • Calcium-Regulating Hormones and Agents / pharmacology
  • Calcium-Regulating Hormones and Agents / therapeutic use*
  • Humans
  • Osteoporosis / drug therapy*
  • Osteoporosis / genetics
  • Osteoporosis / metabolism

Substances

  • Bone Density Conservation Agents
  • Calcium-Regulating Hormones and Agents