Osteoporosis weakens bones, making them more likely to break from minor falls or everyday activity. About 10 million Americans have osteoporosis, with another 44 million at risk due to low bone density. Current treatments include bisphosphonates like alendronate, denosumab injections, and newer bone-building drugs like romosozumab and abaloparatide.
What's actually going on in research
Trials are testing longer-acting treatments, combination therapies that both build and preserve bone, and drugs that target different bone metabolism pathways. Researchers are studying how to predict fracture risk more accurately, whether to treat people with pre-osteoporosis, and how to maintain bone strength after stopping medication. Some studies explore ways to reverse bone loss rather than just slow it.
Sclerostin inhibitors
Romosozumab blocks sclerostin, a protein that limits bone formation, and was FDA-approved in 2019. Trials are now testing whether combining it with other drugs produces better results than sequential use.
Cathepsin K inhibitors
These drugs aim to slow bone breakdown while preserving bone formation, a more selective approach than bisphosphonates. Early trials showed promise, though cardiovascular concerns paused some development.
Extended dosing strategies
Studies are testing whether people can take drug holidays from bisphosphonates or denosumab without losing protection against fractures. This matters because many people stay on these drugs for years.
What to know before you search
Eligibility typically depends on bone density scores, prior fractures, age, and whether you've taken osteoporosis medications before.
What types of trials are currently open
- Treatment trials — Testing new medications or combinations to see if they increase bone density and reduce fracture risk more effectively than current drugs.
- Fracture prevention trials — Following participants for several years to count actual broken bones, not just changes in bone density scans.
- Drug holiday trials — Testing whether people can safely stop medication temporarily after years of treatment while maintaining bone strength.
- Men's osteoporosis trials — Most osteoporosis research has focused on postmenopausal women, so trials are now specifically enrolling men.
- Observational studies — Tracking bone health over time to identify risk factors and understand who responds best to different treatments.
Recently added Osteoporosis trials
Donate a blood sample to help identify hidden bone fragility
Osteoporosis is a major cause of morbidity and fragility fractures in postmenopausal women. Bone mineral density (BMD) alone may not fully reflect fracture risk and skeletal fragility. Lumican, an extracellular matrix proteoglycan involved in collagen organization and musculoskeletal tissue homeostasis, has emerged as a potential biomarker for bone health. This prospective observational study aims to investigate the relationship between serum lumican levels, bone mineral density, muscle strength, and clinical fragility indicators in postmenopausal women. Approximately 100 participants will undergo routine osteoporosis assessment including DEXA, laboratory testing, FRAX evaluation, and handgrip strength measurement. The study will evaluate whether serum lumican levels can identify a hidden fragility phenotype beyond conventional bone mineral density measurements.
Complete bone scans and strength tests to evaluate muscle-bone health connection
The Functional Muscle-Bone Incongruity Index (FKUI) is a novel approach developed to evaluate the relationship between muscle function and bone health. This prospective observational study aims to investigate the clinical applicability of FKUI, which combines handgrip strength, total hip bone mineral density (BMD), and lumbar-hip BMD discordance. Approximately 200 adult participants undergoing routine DXA assessment will be enrolled. The study will examine whether the combined evaluation of muscle function and bone health parameters provides a more comprehensive assessment of musculoskeletal status than individual measures alone.
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