Long-term and sequential treatment for osteoporosis
Abstract
Osteoporosis is a skeletal disorder that causes impairment of bone structure and strength, leading to a progressively increased risk of fragility fractures. The global prevalence of osteoporosis is increasing in the ageing population. Owing to the chronic character of osteoporosis, years or even decades of preventive measures or therapy are required. The long-term use of bone-specific pharmacological treatment options, including antiresorptive and/or osteoanabolic approaches, has raised concerns around adverse effects or potential rebound phenomena after treatment discontinuation. Imaging options, risk scores and the assessment of bone turnover during initiation and monitoring of such therapies could help to inform individualized treatment strategies. Combination therapies are currently used less often than 'sequential' treatments. However, all patients with osteoporosis, including those with secondary and rare causes of osteoporosis, as well as specific patient populations (for example, young adults, men and pregnant women) require new approaches for long-term therapy and disease monitoring. New pathophysiological aspects of bone metabolism might therefore help to inform and revolutionize the diagnosis and treatment of osteoporosis.
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Other current osteoporosis treatments, including antiresorptives and osteoanabolic therapies, have limitations on their duration of use, typically ranging from one to five years.
“Other current osteoporosis treatments, including antiresorptives and osteoanabolic therapies, have limitations on their duration of use, typically ranging from one to five years [52].”
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Stadt, M. M., & Layton, A. T. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.05.01.651663
- Authors
- Foessl, I., Dimai, H. P., & Obermayer-Pietsch, B.
- Affiliations
- Medical University of Graz (AT)
- University of Graz (AT)
- Corresponding author
- Obermayer-Pietsch, Barbara
- Venue
- Nature Reviews Endocrinology
- Published
- 2023-07-18
- Volume
- 19
- Issue
- 9
- Pages
- 520-533
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W4384662556
- Cited by
- 273
- References
- 20
- Citations by year
- 2026: 76 · 2025: 116 · 2024: 75 · 2023: 6
- FWCI
- 15.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- osteoporosis, long-term treatment, sequential therapy, antiresorptive agents, osteoanabolic agents, treatment discontinuation, rebound effect, bone turnover markers, bone metabolism, fragility fractures, secondary osteoporosis, young adults, men, pregnancy, treatment monitoring
- MeSH terms
- Female, Humans, Male, Osteoporosis, Pregnancy, Risk Factors, Bone Density, Bone Density Conservation Agents, Fractures, Bone
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