Newer Therapies for Osteoporosis: A Systematic Review.

Objective: The current management of osteoporosis has several unmet needs. Consequently, the newer and upcoming agents and targets are being expectantly looked at. We aim to appraise the evidence examining the efficacy of the newer therapies for the management of osteoporosis.

Methods: Scopus, Embase, and MEDLINE databases were screened from January 2013 to December 2023 to identify clinical trials that evaluated the efficacy of newer agents for the treatment of osteoporosis in men and postmenopausal women (PMO). Changes in bone mineral density (BMD) and incidences of vertebral fractures (VFs) and nonvertebral fractures (NVFs) or relative risk reduction (RRR) for VF and NVF were retrieved. The Oxford quality scoring system was applied to evaluate the methodological quality of the included clinical trials.

Results: Eighteen randomized controlled trials (RCTs) that had enrolled 22,868 PMO and 473 male participants were included. Anabolic agents abaloparatide and romosozumab exhibited significant BMD gain and relative RRR for fractures and greater efficacy than teriparatide. Blosozumab was reported to exhibit substantial BMD gains. The efficacy of a sequential therapeutic strategy with anabolic agent followed by antiresorptive agents was superior to the reverse sequence.

Conclusion: Newer therapies for osteoporosis exhibited significant BMD gain and fracture risk reduction in men and PMO. The newer anabolic agents demonstrated greater efficacy than any of the previously available therapeutic options.