COMPARISON BETWEEN ANABOLIC AND ANTIRESORPTIVE THERAPIES IN OSTEOPOROSIS: ANTIFRACTURE EFFICACY AND THERAPEUTIC STRATEGY

Authors

  • Felipe Dias Gonçalves Author
  • Aliandro Willy Duarte Magalhães Author
  • Dalmir Júnior Ferreira Rodrigues Author
  • Henri Ryoji Sasaki Filho Author
  • Lucas Radi Cruvinel Author
  • Ricardo Prado Lyra Author
  • Amanda Mendonça Reginaldo Author
  • Isadora Martinez Vilela Author
  • José Ribeiro Krauze da Silva Author
  • Giuliana Valderano de Lima Author
  • Henrique Gregório Nolasco Author
  • Diegomaier Nunes Neri Author
  • Laila Aeid da Costa Yisuf Author
  • Danielle Cristine Bezerra Costa Author
  • Paulo Vitor Moreira Barbosa Author
  • Ravylla Moreira dos Santos Author
  • Camila Stafforti de Moraes Author
  • Pyetro Mesquita dos Santos de Oliveira Author
  • Ivna Paola Arruda Câmara Virgolino Author
  • Nicole Barbosa Amaral Author

DOI:

https://doi.org/10.56238/levv17n58-037

Keywords:

Osteoporosis, Anabolic Therapy, Antiresorptive Therapy, Fracture Prevention, Osteoporosis Treatment

Abstract

Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density and deterioration of bone microarchitecture, which significantly increases the risk of fragility fractures. In this context, different pharmacological approaches have been used in the treatment of the disease, particularly antiresorptive and anabolic therapies. The present study aimed to compare the antifracture efficacy of these therapies and discuss their implications for therapeutic planning in patients with osteoporosis. This study is an integrative literature review conducted using the PubMed/MEDLINE, SciELO, and ScienceDirect databases. Articles published between 2016 and 2026, available in full text in Portuguese or English, addressing the effectiveness of anabolic and antiresorptive therapies in preventing osteoporotic fractures were included. After applying the inclusion and exclusion criteria, 15 scientific studies were selected to compose the final sample of the review. The results indicated that antiresorptive therapies remain widely used as first-line treatment due to their proven effectiveness in reducing the risk of vertebral, non-vertebral, and hip fractures. On the other hand, anabolic therapies have shown significant benefits in patients with severe osteoporosis or at high fracture risk, promoting greater increases in bone mineral density. In addition, recent evidence suggests that sequential therapeutic strategies, involving initial use of anabolic agents followed by antiresorptive drugs, may provide better clinical outcomes. It is concluded that both therapeutic classes play an important role in the management of osteoporosis, highlighting the importance of individualized treatment according to each patient's clinical profile and fracture risk.

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References

BODY, Jean-Yves et al. Efficacy of teriparatide compared with risedronate in reducing fracture risk in postmenopausal women with severe osteoporosis: post hoc analysis of the VERO trial. Osteoporosis International, London, v. 31, n. 5, p. 1057-1066, 2020.

COSMAN, Felicia et al. Romosozumab treatment in postmenopausal women with osteoporosis. The New England Journal of Medicine, Boston, v. 375, n. 16, p. 1532-1543, 2016.

CUMMINGS, Steven R. et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. The New England Journal of Medicine, Boston, v. 361, n. 8, p. 756-765, 2009.

DAMM, Torben et al. Effects of romosozumab on bone structure and strength in postmenopausal women with osteoporosis. Journal of Bone and Mineral Research, Hoboken, v. 40, n. 2, p. 215-223, 2025.

DAVIS, Sian et al. Systematic review and meta-analysis of antiresorptive therapies for the prevention of fractures in osteoporosis. Osteoporosis International, London, v. 31, n. 4, p. 715-726, 2020.

GEUSENS, Piet et al. Effects of teriparatide compared with risedronate on the risk of fractures in postmenopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. The Lancet, London, v. 391, n. 10117, p. 230-240, 2018.

HAUSER, Bernhard; ALONSO, Nerea; RICHES, Philip. Clinical management of severe osteoporosis and the role of anabolic therapy. Therapeutic Advances in Musculoskeletal Disease, London, v. 13, p. 1-14, 2021.

HÄNDEL, Mina N. et al. Fracture risk reduction and safety by osteoporosis medications: systematic review and network meta-analysis. BMJ, London, v. 381, p. e072330, 2023.

LANGDAHL, Bente L. et al. Romosozumab versus teriparatide in postmenopausal women with osteoporosis previously treated with bisphosphonate therapy: a randomised controlled trial. The Lancet, London, v. 390, n. 10102, p. 1585-1594, 2017.

MCCLUNG, Michael R. et al. Romosozumab efficacy in postmenopausal women with osteoporosis at high risk of fracture. Journal of Bone and Mineral Research, Hoboken, v. 38, n. 5, p. 846-855, 2023.

PATEL, Rupal; LYERLY, W. Grant; HORLEN, Charles. Anabolic therapies for osteoporosis: current evidence and future directions. Therapeutic Advances in Musculoskeletal Disease, London, v. 12, p. 1-12, 2020.

SAAG, Kenneth G. et al. Romosozumab or alendronate for fracture prevention in women with osteoporosis. The New England Journal of Medicine, Boston, v. 377, n. 15, p. 1417-1427, 2017.

SILVA, Bruno Costa et al. Brazilian guidelines for the diagnosis and treatment of osteoporosis in postmenopausal women and older men. Archives of Endocrinology and Metabolism, São Paulo, v. 66, n. 4, p. 567-589, 2022.

VITHRAN, Dinesh et al. Comparative effectiveness of anabolic and antiresorptive therapies in osteoporosis: a systematic review and meta-analysis. Bone, Amsterdam, v. 178, p. 116801, 2024.

YANG, Peng et al. Effects of teriparatide compared with risedronate in the treatment of osteoporosis: a systematic review and meta-analysis. Bone, Amsterdam, v. 130, p. 115121, 2020.

Published

2026-03-16

How to Cite

GONÇALVES, Felipe Dias et al. COMPARISON BETWEEN ANABOLIC AND ANTIRESORPTIVE THERAPIES IN OSTEOPOROSIS: ANTIFRACTURE EFFICACY AND THERAPEUTIC STRATEGY. LUMEN ET VIRTUS, [S. l.], v. 17, n. 58, p. e12541, 2026. DOI: 10.56238/levv17n58-037. Disponível em: https://periodicos.newsciencepubl.com/LEV/article/view/12541. Acesso em: 17 mar. 2026.