Surface-specific bone formation effects of osteoporosis pharmacological treatments

Research output: Contribution to journalReview article

3 Scopus citations

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 (US)
Pages (from-to)62-69
Number of pages8
JournalClinical Reviews in Bone and Mineral Metabolism
Volume6
Issue number1-2
DOIs
StatePublished - Jun 1 2008

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

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