Osteoporosis medications can be classified as either antiresorptive or anabolic based
on their mechanism of action. The most commonly used antiresorptive agents include
the nitrogen-containing bisphosphonates and the receptor activator of NFκB (RANK)-
ligand inhibitor, denosumab. The currently available anabolic drugs, teriparatide and
abaloparatide, both act through binding to the PTH/PTHrP receptor, and are generally
reserved for patients with more significant disease. In contrast to other chronic diseases
such as hypertension or diabetes, osteoporosis therapy has generally been limited to the sequential administration of a standard dose of a single medication. More recently,
however, the efficacy of several combined anabolic/antiresorptive approaches to
osteoporosis have been evaluated in clinical trials. Moreover, as osteoporosis treatment
options continue to expand, and clinical guidelines have begun to include the concept of
limiting treatment courses to several years, defining the optimal use of multiple agents
in sequence has also become an area of increasing interest. In this webinar, we will
review the relative efficacy of the various approaches to combination osteoporosis
therapy as well as the comparative skeletal effects of the various sequential approaches
evaluated to date.
- Understand the relative skeletal effects and clinical efficacy of the various approaches to combined anabolic/antiresorptive osteoporosis therapy investigated to date.
- Be familiar with the potential mechanisms that underlie the specific efficacy of combined PTH-analog and RANKL-inhibition therapy.
- Recognize the relative efficacy of the various sequential approaches in osteoporosis therapy as well as the optimal way to consolidate bone mineral density gains achieved with combination, anabolic, or RANKL-inhibition therapy.