Table 1 Pros and cons of various drugs used in the treatment of osteoporosis. Conventional drug delivery systems for osteoporosis have limitations including low selectivity, poor bioavailability, short half-life, potential side effects, invasive administration routes, lack of targeted delivery, and limited control over drug release. Addressing these limitations is a current area of research for improved therapeutic approaches
From: Emerging nano-scale delivery systems for the treatment of osteoporosis
Ref. No. | Material | Character | Pros | Cons |
|---|---|---|---|---|
[44] | Statin | Inhibitors of hydroxymethylglutaryl-CoA reductase (cholesterol-lowering) | Stimulates bone formation by upregulating bone morphogenic protein-2 (BMP-2) in bone cells | High dosage can increase OP risk |
Strontium-related compound | Alkaline earth metal (highly reactive) | Decreases fracture risk by increasing bone stiffness, stimulates osteoblastic activity, and inhibits bone absorption by osteoclasts (OC) | High dosage can cause several side effects | |
[47] | Ceria | An oxide of the rare-earth metal cerium | It has oxidative activity in the low-pH microenvironment generated by OCs and upregulates reactive oxygen species, which can decrease the viability of OCs. | Long-term use can induce cytotoxicity and genetic modification |
[48] | W9 peptide | An antagonist of receptor activator for nuclear factor-κappa beta ligand (RANKL) and tumor necrosis factor-α (TNF-α) | Inhibits osteoclastogenesis and OC activity by suppressing autophagy and promoting apoptosis | The peptide can self-aggregate and is easily degraded in the body |
[49] | Calcitonin -related peptide | A member of the calcitonin family of peptides that is found in the peripheral and central nervous systems | Activates the proliferation of BMSCs and promotes their osteogenic differentiation in physiological conditions | The peptide can self-aggregate and is easily degraded in the body |
[50] | Raloxifene | A member of the synthetic compound for selective estrogen receptor modulators | Decreases accelerated bone turnover, increases bone mineral density, and recovers lost bone tissue in postmenopausal OP; decreases the risk of fractures in patients with previous vertebral fractures | Long-term use can cause side effects |
[51] | Bisphosphonate | Inorganic pyrophosphate; have two phosphonate [PO(OH)2] groups | Can target bone tissue and reduce the activity of OCs. | High dosage can cause esophageal cancer and osteonecrosis |
[52] | Salmon calcitonin | Synthetic calcitonin hormone | Inhibits bone resorption, prevents bone loss, and decreases fracture risk | High dosage can cause several side effects, and it is easily degraded in the body |
[53] | Nucleic acid (RNA or DNA) | Used for gene therapy (gene editing and silencing) | Highly effective and can cure genetic diseases | Easily degraded by endogenous nucleases |
[54] | Estrogen | Regulates the growth, differentiation, and functions of various tissues in women and maintains the female reproductive physiology | Direct effect on OCs and OBs to modulate trabecular versus cortical bone mass | Long-term use can cause side effects |
[55] | Curcumin | Effective antioxidant | Stimulates the apoptosis of OCs, inhibits bone resorption, and suppresses osteoclastogenesis through the RANKL pathway | Low water solubility (lipid-soluble) |
[56] | Icariin | Pharmacologically active flavonoid glycoside | Promotes bone formation by stimulating the osteogenic differentiation of BMSCs while inhibiting their osteoclastogenic differentiation | Low water solubility and low bioavailability after oral administration |
[57] | Quercetin | Plant-derived flavonoid | Inhibits RANKL-mediated osteoclastogenesis, OB apoptosis, oxidative-stress generation, and inflammatory responses while promoting osteogenesis, angiogenesis, antioxidant expression, adipocyte apoptosis, and OC apoptosis | Low water solubility and low bioavailability after oral administration |
[58] | Odanacatib | Inhibitor of cathepsin K (related to bone resorption) | Increases bone mineral density, inhibits bone resorption of OCs and their differentiation | Low water solubility and low bioavailability after oral administration |