Surface-specific bone formation effects of osteoporosis pharmacological treatments

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Current anti-osteoporotic pharmacological treatments reduce fracture risk in part by altering bone remodeling/modeling. These effects can manifest on any or all of the bone envelopes-periosteal, intracortical, and trabecular/ endocortical-each of which has unique effects on the biomechanical properties of bone. The purpose of this review is to provide an overview of how the most common FDA-approved anti-osteoporosis agents [bisphosphonates, estrogen/hormone replacement therapy, selective estrogen receptor modulators (SERMs), and parathyroid hormone (PTH)] affect tissue-level remodeling/modeling on each of the bone surfaces. Iliac crest biopsy data, the only means of assessing surface-specific bone formation in humans, exist for all of these agents although they predominately focus on trabecular/endocortical surfaces. Data from pre-clinical animal models provide an essential complement to human studies, particuarily for changes on periosteal surfaces and within the intracortical envelope. Although all of the anti-catabolic agents (estrogen replacement therapy, SERMs, bisphosphonates) exert positive effects on the various bone surfaces, the bisphosphonates produce the unique biomechanical combination of allowing normal periosteal expansion while limiting remodeling-induced bone loss on intracortical and trabecular/endocortical surfaces. PTH, the only FDA-approved anabolic agent, exerts biomechanically favorable alterations though enhanced trabecular/endocortical surface activity while also stimulating periosteal expansion. Through understanding how current and future anti-osteoporotic agents influence surface-specific bone activity we will move one step closer to developing agents that could potentially target a particular bone surface.

Original languageEnglish
Pages (from-to)62-69
Number of pages8
JournalClinical Reviews in Bone and Mineral Metabolism
Volume6
Issue number1-2
DOIs
StatePublished - Jun 2008

Fingerprint

Osteogenesis
Osteoporosis
Pharmacology
Bone and Bones
Diphosphonates
Selective Estrogen Receptor Modulators
Estrogen Replacement Therapy
Bone Remodeling
Parathyroid Hormone
Therapeutics
Anabolic Agents
Hormone Replacement Therapy
Animal Models
Biopsy

Keywords

  • Bisphosphonates
  • Estrogen/hormone replacement therapy
  • Parathyroid hormone
  • Selective estrogen receptor modulators (SERMs)

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

Cite this

Surface-specific bone formation effects of osteoporosis pharmacological treatments. / Allen, Matthew.

In: Clinical Reviews in Bone and Mineral Metabolism, Vol. 6, No. 1-2, 06.2008, p. 62-69.

Research output: Contribution to journalArticle

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