As per a recent study of the British Journal of Clinical Pharmacology, Teriparatide, Abaloparatide and Romosozumab are the new anabolic therapies for osteoporosis management. Abaloparatide (ABL) and Teriparatide (TPTD) are previously available therapies, and Romosozumab is under the examination.

The ABL is an analogue of the parathyroid hormone-related peptide (PTHrP) with considerably different amino acids included between residues 22 and 34. The TPTD is a recombinant 34–amino acid fragment that shows similar principal sequence as the human parathyroid hormone [hPTH(1‐84)].

Parathyroid hormone (PTH) shows osteoanabolic actions directly by affecting osteoblast lineage cells and indirectly by prompting IGF‐I synthesis and inhibiting sclerostin and related improvement of Wnt signalling. Both ABL and TPTD binds and stimulate the PTH receptor type 1 (PTHR1) receptor, though they seem to do so differently. ABL supports the transient, more anabolic arrangement of the receptor. The risk of non-vertebral fractures and vertebral fractures was reduced by both ABL and TPTD. Both drugs are delivered maximum for 24 months and should be succeeded by an anti‐resorptive agent to control increase in BMD.

Romosozumab is a monoclonal antibody which shows its action by binding and suppressing sclerostin. It is associated with a rapid but very transient increase in bone formation markers. In the pivotal clinical analysis, Romosozumab 210 mg delivered subcutaneously decreases fracture risk but it is not clear whether it is associated with an increase in serious cardiovascular adverse effects.