Metabolic Bone Diseases and New Drug Developments

Abstract

Metabolic bone diseases are serious health issues worldwide, since several million individuals over the age of 50 are at risk of bone damage and should be worried about their bone health. One in every two women and one in every four men will break a bone during their lifetime due to a metabolic bone disease. Early detection, raising bone health awareness, and maintaining a balanced healthy diet may reduce the risk of skeletal fractures caused by metabolic bone diseases. This review compiles information on the most common metabolic bone diseases (osteoporosis, primary hyperparathyroidism, osteomalacia, and fluorosis disease) seen in the global population, including their symptoms, mechanisms, and causes, as well as discussing their prevention and the development of new drugs for treatment. A large amount of research literature suggests that balanced nutrition and balanced periodic supplementation of calcium, phosphate, and vitamin D can improve re-absorption and the regrowth of bones, and inhibit the formation of skeletal fractures, except in the case of hereditary bone diseases. Meanwhile, new and improved drug formulations, such as raloxifene, teriparatide, sclerostin, denosumab, and abaloparatide, have been successfully developed and administered as treatments for metabolic bone diseases, while others (romososumab and odanacatib) are in various stages of clinical trials.

Keywords: Metabolic bone diseases; New drugs; Odanacatib; Osteomalacia; Osteoporosis.

Fig. 1

Most familiar metabolic bone diseases (MBDs). The most common MBDs recognized among the global population are osteomalacia, osteoporosis, primary hyperthyroidism, and fluorosis, which are caused by abnormalities in essential minerals such as Ca, P, and vitamin D, resulting in loss of bone mass and structure.

Fig. 2

Bone with Osteoporosis. Osteoporosis (silent disease) causes the bones to become brittle and fragile due to tissue loss, weakening the bones at specific sites (e.g. hip, spine, wrist, and so on) and causing them to break easily.

Fig. 3

Clinical complication associated with Primary hyperparathyroidism (PHPT). The imbalanced thyroid hormone condition causes a slew of health issues such as obesity, hypertension, chronic kidney disease, kidney stones, and so on. Such health complications can be managed through a well-balanced nutritional supplementation of the diet.

Fig. 4

Bone with Rickets/Osteomalacia. Skeletal muscle soreness and vulnerability may occur as a result of the patient`s bone softening. The lower back, femur, hips, thighs, and rib bones are among the most commonly affected areas in osteomalacia.

Fig. 5

Various forms of fluorosis. The skeletal and non-skeletal fluorosis can affect the bones and joints due to extended exposure to an elevated quantity of fluoride and causing additional discomforts such as arthritis, osteoporosis, chronic joint pain, and so on.

Fig. 6

Chemical Structure of Raloxifene, Teriparatide and Abaloparatide.

Fig. 7

Chemical Structure of Bisphosphonates and Denosumab.