ABSTRACT
Clearly the antiresorptives are far from being the ‘Holy Grails’ o f osteoporosis therapy although they do break the vicious cyle o f escalating remodeling and microdamage (Fig. 10). Since by the time o f their first fracture, the bones o f osteoporotic postmeno pausal women have undergone considerable microarchitectural deterioration (e.g., increased cortical osteonal porosity [R.B. Martin et al., 1998; Sietsema, 1995]) and have lost about 30% o f their bone mass because o f escalating microfracturing and resulting remodeling activity, it is essential to find something that can increase bone mass a lot more than the 6-10% which is the most that can be got from a 3-year treatment with the various anti-catabolics. The ideal drug for treating osteoporosis and accelerating fracture healing in both women and men (without accelerated remodeling?) would be a true an abolic that direcdy stimulates osteoblast produc tion which actually makes strong new bone instead o f just permitting the unopposed fdling o f existing remodeling holes by murdering osteoclasts and lowering the remodeling activity to a “normal” or even subnormal level.
