Osteoporosis is a pathological loss of bone mass due to an imbalance in bone remodeling
where osteoclast-mediated bone resorption exceeds osteoblast-mediated bone formation
resulting in skeletal fragility and fractures. Anti-resorptive agents, such as bisphosphonates
and SERMs, and anabolic drugs that stimulate bone formation, including PTH analogues
and sclerostin inhibitors, are current treatments for osteoporosis. Despite their efficacy, severe
side effects and loss of potency may limit the long term usage of a single drug. Sequential and
combinational use of current drugs, such as switching from an anabolic to an anti-resorptive
agent, may provide an alternative approach. Moreover, there are novel drugs being developed
against emerging new targets such as Cathepsin K and 17β-HSD2 that may have less side effects.
This review will summarize the molecular mechanisms of osteoporosis, current drugs for
osteoporosis treatment, and new drug development strategies.