After Bisphosphonate Use, Which Bone-Forming Medication Is Best?

An experimental monoclonal antibody, but not the FDA-approved teriparatide, increased bone-mineral density in former users of bisphosphonates.

Although bisphosphonates, the commonly prescribed antiresorptive agents, represent mainstream therapy for osteoporosis, some patients develop fractures during long-term treatment or cannot tolerate this class of medications. For these patients, clinicians often prescribe the bone-forming agent teriparatide (Forteo). However, teriparatide's ability to increase bone-mineral density (BMD) appears to be attenuated in former users of antiresorptive agents. In an industry-funded trial, investigators compared teriparatide with romosozumab, a non-FDA-approved monoclonal antibody that binds to and inhibits sclerostin (the negative regulator of bone formation) and thus inhibits bone resorption and stimulates bone formation.

In a 12-month, phase IIIB, …

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

After Bisphosphonate Use, Which Bone-Forming Medication Is Best?

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Reviewing Author