Osteoporosis drugs are administered through different routes in the body, like orally or intravenously. Osteoporosis affects around 200 million people worldwide and is a progressive disease in which bones become more porous and fragile, often without symptoms until the first fracture occurs.
The World Health Organization reports that about 1.66 million hip fractures occur worldwide per year owing to osteoporosis. According to the National Osteoporosis Foundation, about 54 million Americans suffer from osteoporosis. The disease also has a genetic bias in that it affects more Caucasians than Asians. The incidence of the disease is lowest in the African community.
Osteoporosis drug classes:
Parathyroid Hormone Therapy
There has recently been a dramatic increase in the clinical study of parathyroid hormone ( PTH). There are no other anabolic agents on the horizon at present, but there are a large number of concerns that remain regarding this effective osteoporosis agent.
The present study discusses clinical trials utilizing PTH alone and in combination and sequence of antiresorptive agents in postmenopausal women and offers a brief review of glucocorticoid-induced osteoporosis studies in men. Because PTH improves microarchitecture, macroarchitecture, and bone density, it may have better long-term fracture protection when provided first and followed by antiresorptive therapy compared to antiresorptive agents alone.
Rank Ligand Inhibitors
When the rate of bone resorption exceeds that of bone formation, bone tissue destruction occurs, leading to a fragile skeleton. Clinical consequences, namely osteoporosis, and fracture fragility are common and severe problems.
Treatments that normalize bone turnover by inhibiting bone resorption preserve bone density and raising the likelihood of fracture. The identification of a key osteoclast activity regulator of the receptor activator of nuclear factor-B ligand (RANKL) offers a new therapeutic target. Initial tests have demonstrated that denosumab, an investigational, extremely selective anti-RANKL antibody, inhibits bone resorption quickly and substantially.
Bisphosphonates
Bisphosphonates are a type of osteoporosis drug used to reduce the loss of bone density and to treat osteoporosis and related diseases. These are the most widely used medications available for the treatment of osteoporosis. They are called bisphosphonates because they have two groups of phosphonates. They are also called diphosphonates. Bisphosphonates were prescribed as first-line therapy for postmenopausal osteoporosis.
Long-term treatments of bisphosphonates induce anti-fracture and bone mineral growth results that persist 3–5 years following the original 3–5 years of care. Biphosphonate alendronate decreases the risk of hip, vertebral, and wrist fractures by 35-39%; zoledronate reduces the risk of hip fractures by 38% and vertebral fractures by 62%. Risedronate has also been shown to reduce the possibility of hip fractures.
Factors behind the growing incidence of osteoporosis disorders:
Drugs and health conditions
Some illnesses or medications induce changes in hormone levels, and other medicines decrease bone density. Diseases affecting hormone levels include hyperthyroidism, hyperparathyroidism, and Cushing's syndrome. Research published in 2015 suggests that transgender women receiving hormone treatment (HT) may have an increased risk of osteoporosis. Nevertheless, the use of anti-androgens for a year before starting HT may reduce this risk.
Medical problems that raise the risk include certain autoimmune diseases, such as rheumatoid arthritis and ankylosing spondylitis, Cushing syndrome, adrenal gland dysfunction, pituitary gland disorders, among several others. Risk-enhancing medications include glucocorticoids and corticosteroids, including prednisone and prednisolone, thyroid hormones, anticoagulants and blood thinners, including heparin and warfarin, among many others.
Risk of Developing Osteoporosis Rises With Age
As with many chronic diseases, getting older puts you at a higher risk of osteoporosis. Currently, 1 in 4 American people over the age of 65 and 1 in 20 males over the same group have osteoporosis, according to the Centers for Disease Control and Prevention (CDC). In adults, bones undergo a continual cycle of breaking down and rebuilding, called remodeling. Osteoblasts make bones and osteoclasts break down the tissue in the bones and release the minerals into the blood.
The hormones androgen and estrogen have a role to play in the balance between bone breakdown and bone reconstruction. As people get older and these hormone levels drop, the bone is removed or damaged faster than the body can replace it, leaving bones weakened and vulnerable to fracture. Unhealthy lifestyle habits, such as smoking, alcohol, and lack of exercise, often raise the likelihood of having osteoporosis, as does long-term usage of some types of medication, including corticosteroids.
Osteoporosis In Males
Osteoporosis is a disease defined by decreased bone strength and increased risk of fractures. Classically, this disease has been a postmenopausal woman, although a significant health burden is increasingly recognized in men as well. Men experience higher mortality and morbidity from osteoporotic fractures compared to women. The lack of studies in men, the lack of reimbursement of DEXA scans in men and the lack of agreement among organizations are obstacles to the diagnosis and care of osteoporosis in men. Approximately 50% of men have an identifiable cause of osteoporosis, i.e. secondary osteoporosis.
When no cause is found after an extensive assessment, it is referred to as age-related osteoporosis in men over 70 years of age and idiopathic osteoporosis in men below 70 years of age. There are various reasons for a decreased risk of fracture in males compared to females. Bone mass accumulation begins from childhood and increases exponentially during puberty. While men appear to get this acceleration later than women, they may reach higher peak bone mass due to larger bones and greater periosteal expansion. Such wider bones contribute to improved biomechanical strength and decreased risk of fracture.
The bottom line
The osteoporosis drug market is growing at a rapid rate owing to the constantly rising rate of osteoporosis. There is a lack of osteoporosis drugs with a good safety profile that has been shown to reduce the risk of fracture in the elderly and the very elderly. Of all these purposes, the development of new bone active substances for the treatment of osteoporosis and the prevention of fractures is urgently needed.
Free Valuable Insights: Global Osteoporosis Drugs Market to reach a market size of USD 10.9 billion by 2026
According to the current treatment paradigm, antiresorptive drugs are the mainstay first-line therapy to reduce the risk of fracture in patients with osteoporosis and anabolic substances are usually only recommended in patients with severe osteoporosis. Since lost bone microarchitecture cannot be recovered, a future treatment paradigm may aim to reverse osteoporosis by maximizing bone mass and preserving bone microarchitecture during the early stage of disease progression.
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