Antiresorptive and Anabolic Agents
There are two primary types of drug therapy for osteoporosis: antiresorptive agents and anabolic agents. Antiresorptive drugs reduce bone loss, while anabolic agents stimulate new bone formation. While there is strong evidence from controlled clinical trials for the effectiveness of these agents in reducing fractures, direct head-to-head trials are needed to provide the best evidence of comparative antifracture efficacy. Unfortunately, such trials with fracture endpoints are not available. In the absence of direct comparative trials, attempts have been made to compare the relative risk reduction for fractures for the different antiresorptive agents based on their respective clinical trials,³⁰ but such comparisons have their limitations and true comparative information awaits appropriately designed head-to-head randomized trials.³¹