Osteoporosis is a condition of compromised bone quality and bone density increasing the chances of fracture. In osteoporotic bone, there is a mismatch between bone formation and resorption. The high probability in both women (33.33%) and males (20%) over the age of 50 worldwide to suffer a fracture draws attention to the importance of treatment of osteoporosis. The benefits of using bisphosphonates, the first line of therapy in osteoporosis lasts for 5 years. The other drugs are recommended for a still shorter time. The state of usage of current drugs is discussed. Two drugs Abaloparatide and Romosozumab have been recently approved. There is a better understanding of the means of communication amongst the different players in bone remodeling. These players involved in remodeling, are subjected to local and systemic influences. This increased understanding of physiology led to molecules being investigated which acts on newer targets such as Cathepsin K, ɑ v β 3 integrin, chloride channel 7, tryptophan hydroxylase 1, Src, calcium-sensing receptor. Also, a bone anabolic effect for certain drugs belonging to different therapeutic classes such as statins, nitrates, thiazides, beta-blockers has been noted. However, for these drugs, further studies regarding the dose and frequency of drug administration and the effectiveness in the prevention of fractures along with safety profiles are needed. The drugs acting on new targets and new uses of old drugs hold hope to increase our arsenal against osteoporosis and thus preventing the mortality and debility due to fractures.
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