Published in:
01-05-2014 | Review
Challenges for the Development of Bone-Forming Agents in Europe
Published in: Calcified Tissue International | Issue 5/2014
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In recent years, significant advances have been made in the management of osteoporosis, particularly with respect to the development of pharmacological interventions to reduce fracture risk. Approved pharmacological interventions in Europe include bisphosphonates, strontium ranelate, raloxifene, bazedoxifene, denosumab, and parathyroid hormone peptides [1‐4] (Table 1). Treatments are approved for osteoporosis in postmenopausal women, but alendronate, etidronate, risedronate zoledronic acid, and teriparatide are also approved for the prevention and treatment of glucocorticoid-induced osteoporosis in Europe [3], and alendronate, risedronate, zoledronic acid, strontium ranelate, and teriparatide are approved for the treatment of osteoporosis in men.
Table 1
Pharmacological interventions used in the EU for the prevention of osteoporotic fractures [4]
|
Intervention
|
Year of market approval
|
Dosing regimen
|
Route of administration
|
|---|---|---|---|
|
Alendronate
|
1995
|
70 mg once weekly or 5 or 10 mg once daily
|
Oral
|
|
Etidronate
|
1980
|
400 mg daily for 2 weeks every 3 months
|
Oral
|
|
Ibandronate (I)
|
2005
|
150 mg once monthly
|
Oral
|
|
Ibandronate (II)
|
2005
|
3 mg once every 3 months
|
Intravenous injection
|
|
Risedronate
|
2000
|
35 mg once weekly or 5 mg once daily
|
Oral
|
|
Zoledronic acid
|
2005
|
5 mg once yearly
|
Intravenous infusion
|
|
Denosumab
|
2010
|
60 mg twice yearly
|
Subcutaneous injection
|
|
Raloxifene
|
1998
|
60 mg once daily
|
Oral
|
|
Bazedoxifenea
|
2009
|
20 mg once daily
|
Oral
|
|
Strontium ranelate
|
2004
|
2 g once daily
|
Oral
|
|
Teriparatide
|
2003
|
20 μg once daily
|
Subcutaneous injection
|
|
Parathyroid hormone 1–84a
|
2006
|
100 μg once daily
|
Subcutaneous injection
|