Recent advances in the pharmaceutical manipulation of bone remodelling: the quest for a healthy skeleton

Authors

  • Editorial Office
  • E J Raubenheimer Ampath Histopathology Laboratory
  • H D Miniggio Sefako Makgatho Health Sciences University
  • L B Lemmer Ampath Histopathology Laboratory
  • T Slavik Ampath Histopathology Laboratory
  • W F P Van Heerden University of Pretoria

Keywords:

osteoporosis, skeletal health, osteoinductive medication, antiresorptive medication, bone remodelling

Abstract

Introduction: Biochemical characterisation of the autocrine, paracrine and endocrine mediators of bone remodelling provides a scientific basis for the development of pharmaceuticals and autoantibodies which could induce a desired skeletal phenotype. The manipulation of bone remodelling in patients at risk for skeletal disease is gaining clinical momentum due to the benefits of maintaining quality of life rather than restoring the long-term dire consequences of skeletal catabolism.
Methods: A narrative review of current literature pertaining to the modes of action of pharmaceuticals and autoantibodies which manipulate skeletal metabolism was performed.
Results: Pharmaceuticals and autoantibodies which manipulate skeletal remodelling can be broadly divided into three categories: bone resorption inhibitors, bone formation stimulators and bone resorption and formation modulators. The mechanisms of action of these medications are briefly summarised and reference is made to the relevant pharmaceuticals and autoantibodies available.
Level of evidence: Level 5

Author Biographies

E J Raubenheimer, Ampath Histopathology Laboratory

MChD, PhD, DSc

Ampath Histopathology Laboratory

Pretoria; and

Department of Oral Pathology and Oral Biology

University of Pretoria

South Africa

H D Miniggio, Sefako Makgatho Health Sciences University

BDS, MScMed(Bioethics and Health Law)

Unit Oral Biology

Faculty of Health Sciences

Sefako Makgatho Health Sciences University

Pretoria

L B Lemmer, Ampath Histopathology Laboratory

MBChB, MMed(Anat Path)

Ampath Histopathology Laboratory

Pretoria

T Slavik, Ampath Histopathology Laboratory

MBChB, MMed(Anat Path)

Ampath Histopathology Laboratory

Pretoria

W F P Van Heerden, University of Pretoria

MChD, PhD, DSc

Department of Oral Pathology and Oral Biology

University of Pretoria

Pretoria

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Published

2018-05-02

Issue

Section

General Orthopaedics