Aktuelle und zukünftige pharmakologische Therapieoptionen zur Behandlung der Osteoporose und deren Wirkmechanismen – ein Überblick

Zusammenfassung

Aktuell verfügbaren pharmakologischen Therapien zur Behandlung der Osteoporose verfolgen entweder einen antiresorptiven oder osteoanabolen Ansatz oder sind dual wirksam. Antiresorptive Therapien (Bisphosphonate, Denosumab, Östrogene und selektive Östrogenrezeptormodulatoren (SERMs)) erhöhen die Knochenmasse durch Hemmung der Knochenresorption. Osteoanabole Therapien (Teriparatid und Abaloparatid) erhöhen die Knochenmasse durch Stimulierung der Knochenbildung. Als dual wirksam gilt Romosozumab. In diesem Übersichtsartikel werden die aktuellen pharmakologischen Therapieformen bei Osteoporose und ihre Wirkmechanismen vorgestellt. Darüber hinaus werden neue Behandlungsansätze besprochen, wie der Einsatz mesenchymaler Stammzellen (MSCs), Extrazellulärer Vesikel (EVs), die Blockierung des follikelstimulierenden Hormons (FSH) sowie eine individuelle Anpassung der Bisphosphonat-Dosis.

Abstract

Currently available pharmacological therapies for the treatment of osteoporosis pursue either an antiresorptive or osteoanabolic approach or have a dual effect. Antiresorptive therapies (bisphosphonates, denosumab, oestrogens and selective oestrogen receptor modulators (SERMs)) increase bone mass by inhibiting bone resorption. Osteoanabolic therapies (teriparatide and abaloparatide) increase bone mass by stimulating bone formation. Romosozumab is considered to have a dual effect. This review article presents the current pharmacological therapy options for osteoporosis treatment and their mechanisms of action. In addition, new treatment approaches are discussed, such as the use of mesenchymal stem cells (MSCs), extracellular vesicles (EVs), the blocking of follicle-stimulating hormone (FSH) and individualised adjustment of the bisphosphonate dose.

Schlüsselwörter

Osteoporose - antiresorptive Therapie - osteoanabole Therapie - Wirkmechanismus

Keywords

osteoporosis - antiresorptive therapy - osteoanabolic therapy - mechanism of action

Publication History

Received: 07 January 2024

Accepted: 10 April 2024

Article published online:
16 May 2024

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