Session: S57-Challenges and Controversies in Bisphosphonate Therapy
Room 103 (Moscone Center)
Of all the FDA-approved therapies currently available in the treatment of osteoporosis, teriparatide is the only one whose mechanism involves the stimulation of new bone formation. Teriparatide, however, is not a pure anabolic agent as it also stimulates bone resorption. Attempts to separate formation from resorption by combining teriparatide with a bisphosphonate, however, have not proven successful. Additionally, some evidence suggests that prior bisphosphonate treatment inhibits the capacity of teriparatide to stimulate new bone. More recently, however, the combination teriparatide with the RANK-ligand inhibitor, denosumab, has been demonstrated to increase bone mineral density more than either drug alone. In this session, we will discuss the potential use of combination antiresorptive and teriparatide therapy in postmenopausal osteoporosis and explore the mechanisms that may underlie the distinct findings reported in the individual clinical trials to date. Furthermore, we will review the evidence regarding the influence that prior exposure to antiresorptive agents may have on the subsequent patient response to anabolic therapy.
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