Decoding osteoporosis: Understanding the disease, exploring current and new therapies and emerging targets

Abstract

Bone is a dynamic tissue that is constantly changing and adapting through multiple processes such as osteogenesis, modeling, and remodeling, which usually include the coordinated activities of osteoclasts and osteoblasts. However, a disturbance in this cycle may result in complications with bone health. One of this complication is osteoporosis, a condition that affects globally over 0.2 billion people and causes nearly 90 lakhs fractures yearly. Osteoporosis is a complex disorder impacted by a range of variables, including lifestyle choices, physical activity, genetics, hormonal and endocrine systems, comorbidities (pre-existing diseases), and the use of certain drugs. This article delivers a short overview of the osteoporosis, its diagnosis, and management by non-pharmacological and pharmacological interventions and limitations of existing medications. The review article also highlights both emerging medications and novel targets for preventing and managing osteoporosis, providing a comprehensive look at future therapeutic strategies aimed at protecting bone strength and retarding bone loss. New medications for osteoporosis include romosozumab, cinacalcet and tiliroside. Potential novel targets for preventing bone loss and osteoporosis which are explored in current article include Wnt/β-catenin pathway, fibroblast activation protein, NLRP3 inflammasome, cuproptosis, P2X7 receptor, tumor necrosis factor receptor associated factor 3, Krüppel-like factor, Toll like receptor 4, Yes-associated protein and the transcriptional coactivator with PDZ-binding motif and Sirtuin 3.