New and emerging treatments for osteoporosis.

PURPOSE OF REVIEW: This review will focus on three new treatments for postmenopausal osteoporosis which have either been recently released (intravenous ibandronate), or have completed (zoledronic acid) or are currently in (denosumab) phase III trials.

RECENT FINDINGS: A number of agents have demonstrated fracture risk reduction in randomized clinical trials, however, successful treatment of osteoporosis in the individual patient remains a challenge. Adherence to, and persistence with, all current osteoporosis medications are poor, being approximately 50% at 1 year for weekly bisphosphonates. Poor adherence to therapy makes it unlikely that the significant fracture reduction seen in clinical trials will be realized in clinical practice.

SUMMARY: New therapies will not only have to demonstrate safety and efficacy, but also provide some advantage to patient persistence through either less frequent dosing schedules or elimination of gastrointestinal disturbances, the most common adverse effects encountered with bisphosphonates. This review will focus on three such agents that have either been recently released (intravenous ibandronate), or have completed (zoledronic acid) or are currently in (denosumab) phase III trials.