4.6 Review

Epigenetic therapies of osteoporosis

Journal

BONE
Volume 142, Issue -, Pages -

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.bone.2020.115680

Keywords

Osteoporosis; Epigenetics; Therapies

Funding

  1. Italian Ministry of Health, Programma Valere (UniCampania L. Vanvitelli 2019) [RF-2011-02349443, RRC-2017]

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The study of epigenetics has reached its 50th anniversary, with clinical trials exploring various epigenetic therapies for osteoporosis. Main therapeutic approaches include bisphosphonates, targeted therapy blocking the RANK/RANKL pathway, and anti-sclerostin antibody. Future large trials will determine the effectiveness of epigenetic therapies in the real-world management of osteoporosis patients.
The study of epigenetics reaches its 50th anniversary, however, its clinical application is gradually coming into the clinical setting. Osteoporosis is one of the major and widely diffused bone diseases. Pathogenic mechanisms at the epigenetic level may interfere with bone remodeling occurring during osteoporosis. Preclinical models were used to understand whether such events may interfere with the disease. Besides, observational clinical trials investigated epigenetic-related biomarkers. This effort leads to some epigenetic-related therapies in clinical trials for the treatment of osteoporosis. Bisphosphonates (BPs), target therapy blocking RANK/RANKL pathway, and anti-sclerostin antibody (SOST) are the main therapeutic approaches. However, future large trials will reveal whether epigenetic therapies of osteoporosis will remain a work in progress or data will become more robust in the real-world management of these frailty patients.

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