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Journal of Osteoporosis
Volume 2010, Article ID 401581, 5 pages
http://dx.doi.org/10.4061/2010/401581
Review Article

Odanacatib, a New Drug for the Treatment of Osteoporosis: Review of the Results in Postmenopausal Women

1Internal Medicine Department, Rio Hortega University Hospital, Faculty of Medicine, 47013 Valladolid, Spain
2Institute of Endocrinology and Nutrition Research Support Unit, Rio Hortega University Hospital, Faculty of Medicine, 47005 Valladolid, Spain
3RETICEF, 47013 Valladolid, Spain
4Clinical Pharmacology Service, Rio Hortega University Hospital, Valladolid, Spain
5Department of Ginecology, Hospital Rio Carrion, 34005 Palencia, Spain

Received 13 January 2010; Accepted 12 April 2010

Academic Editor: Michael Lewiecki

Copyright © 2010 José Luis Pérez-Castrillón et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Osteoclasts are specialized cells that initiate the process of bone resorption, which has two phases, dissolution of the mineral component and degradation of the organic matrix, in which cathepsin K plays a key role. Cathepsin K inhibitors, which block the activity of cathepsin on bone resorption lacunae, may be a new therapeutic option in osteoporosis. Odanacatib is a nonpeptidic biaryl inhibitor of cathepsin K. Two studies have evaluated the efficacy and safety of odanacatib, a phase I study to determine the dose and a phase II study of safety and efficacy. Due to the long half-life of odanacatib and the similar effects of different doses on bone remodeling markers, a weekly dosage was chosen for the phase II trail, with the best results being obtained with a dose of 50 mg. At 36 months, increases in bone mineral density similar to those produced by other powerful antiresorptive drugs (zoledronate and denosumab) were observed but there were differences in the behaviour of bone remodeling markers. Data on fractures from the phase III trial currently in development are required to confirm these possible advantages.