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30.06.2017 | Therapeutics and Medical Management (S Jan de Beur and B Clarke, Section Editors) | Ausgabe 4/2017

Current Osteoporosis Reports 4/2017

Using Osteoporosis Therapies in Combination

Current Osteoporosis Reports > Ausgabe 4/2017
Michael R. McClung
Wichtige Hinweise
This article is part of the Topical Collection on Therapeutics and Medical Management


Purpose of review

The objective of this review is to update evidence regarding the use of osteoporosis drugs in sequence or in combination to optimize increases in bone mass and strength.

Recent findings

Simultaneous use of denosumab plus teriparatide produces larger increases in BMD than does monotherapy. The use of bisphosphonates or denosumab after teriparatide results in progressive gains in BMD. When switching from bisphosphonates and especially denosumab to teriparatide, an overlap of 6-12 months may prevent the transient loss of BMD in cortical sites. Phase 3 trials document fracture risk reduction with anabolic therapy for 12-18 months followed by an anti-remodeling drug.


With the exception of adding teriparatide to ongoing denosumab therapy, there is little evidence to support the use of more than one osteoporosis drug at a time. In contrast, sequential therapy regimens of anabolic drugs followed by potent anti-remodeling agents will be the new standard for treating patients at imminent risk of fracture.

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