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Implications of Osteoblast-Osteoclast Interactions in the Management of Osteoporosis by Antiresorptive Agents Denosumab and Odanacatib

  • Epidemiology and Pathophysiology (PR Ebeling and EF Eriksen, Section Editors)
  • Published:
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Abstract

Antiresorptive agents, used in the treatment of osteoporosis, inhibit either osteoclast formation or function. However, with these approaches, osteoblast activity is also reduced because of the loss of osteoclast-derived coupling factors that serve to stimulate bone formation. This review discusses how osteoclast inhibition influences osteoblast function, comparing the actions of an inhibitor of osteoclast formation [anti-RANKL/Denosumab (DMAB)] with that of a specific inhibitor of osteoclastic cathepsin K activity [Odanacatib (ODN)]. Denosumab rapidly and profoundly, but reversibly, reduces bone formation. In contrast, preclinical studies and clinical trials of ODN showed that bone formation at some skeletal sites was preserved although resorption was reduced. This preservation of bone formation appears to be due to effects of coupling factors, secreted by osteoclasts and released from demineralized bone matrix. This indicates that bone resorptive activities of osteoclasts are separable from their coupling activities.

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N. A. Sims has received honoraria and reimbursement for travel from Amgen for educational presentations. K. W. Ng declares that he has no conflicts of interest.

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  1. Bone Cell Biology and Disease Unit, St Vincent’s Institute of Medical Research, 9 Princes Street, Fitzroy, Victoria, 3065, Australia

    Natalie A. Sims & Kong Wah Ng

  2. Department of Medicine at St. Vincent’s Hospital, The University of Melbourne, Fitzroy, VIC, Australia, 3065

    Natalie A. Sims & Kong Wah Ng

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Sims, N.A., Ng, K.W. Implications of Osteoblast-Osteoclast Interactions in the Management of Osteoporosis by Antiresorptive Agents Denosumab and Odanacatib. Curr Osteoporos Rep 12, 98–106 (2014). https://doi.org/10.1007/s11914-014-0196-1

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