Osteoporosis is a bone disease where density decreases to the point that fractures can occur with minimal trauma — especially in the spine, hip, and wrist. It is extremely common in older women but also affects men, and hip fractures in particular carry a high risk of disability and death.
What's actually going on in research
Romosozumab, a sclerostin inhibitor that builds bone while also reducing bone breakdown, is being used in high-risk patients, and trials are optimizing treatment sequences with other bone drugs. Anabolic agents like teriparatide and abaloparatide build new bone and are being followed by bisphosphonates or denosumab to maintain gains — and trials are refining the optimal transition strategy. Long-term safety data on denosumab discontinuation, which can cause rebound fractures, is a major ongoing research topic.
Romosozumab (sclerostin inhibitor)
This dual-action drug stimulates bone formation and reduces bone breakdown simultaneously, producing larger bone density gains than previous anabolic drugs in fracture-risk patients.
Anabolic-then-antiresorptive sequencing
Using bone-building drugs first followed by maintenance with bisphosphonates or denosumab appears to maximize and maintain bone density gains; trials are comparing transition strategies.
Denosumab discontinuation risk
Stopping denosumab causes rapid bone loss and increased fracture risk. Trials are testing transition approaches and optimal follow-on therapy to safely discontinue this drug.
What to know before you search
Eligibility depends on bone mineral density (T-score), FRAX 10-year fracture risk, prior fracture history, prior osteoporosis treatment, and age.
What types of trials are currently open
- Drug trials — Testing new anabolic drugs, antiresorptives, or novel combination strategies for fracture prevention.
- Sequencing trials — Comparing treatment sequences of anabolic followed by antiresorptive drugs.
- Men's osteoporosis trials — Testing fracture prevention strategies specifically in men, who are underdiagnosed and undertreated.
- Post-fracture trials — Testing treatment initiation and rehabilitation programs after osteoporotic hip or vertebral fractures.
- Discontinuation safety trials — Identifying safe transition strategies after denosumab treatment.
Recently added Osteoporosis trials
Clinical Relevance of Modifying RANKL Signaling During Folliculogenesis
Female infertility presents a significant societal challenge that will be aggravated in the future due to delayed parenthood. Our translational research suggests that receptor activator of NF-κB ligand (RANKL) is a novel treatment target, during assisted reproductive techniques and that inhibition of this pathway may reduce the impact of aging on the ovary. RANKL is a regulator of bone health, and an antibody (denosumab) blocking RANKL activity is used clinically to treat osteoporosis. Previously, we have shown that inhibition of RANKL increases sperm production in rodents, in human tissue models, and in a subpopulation of infertile men. Now, we show that all factors of the RANKL signalling system are expressed in human and mouse ovaries. Granulosa cell-specific Rankl knockdown lowers the number of primordial follicles, which suggests that RANKL has an important role during early stages of folliculogenesis. Additionally, our data from women undergoing in vitro fertilisation show that follicular fluid concentrations of RANKL and OPG are associated with age and the number of matured follicles, and RANKL inhibition promoted maturation of human oocytes in vitro, which suggests an effect also late in folliculogenesis. Thus, the proposed project aims to: 1) Clarify the role of RANKL in ovaries of mice and humans 2) Determine the reproductive effect of modulating RANKL activity systemically or locally in mice and monkeys 3) Investigate whether manipulation of RANKL can optimise in vitro maturation and rescue of immature human oocytes and 4) Determine whether follicular fluid concentrations of soluble RANKL and OPG may serve as markers of ovarian pathophysiology. The overall aim of this project is to uncover how RANKL regulates follicle reserve and oocyte maturation during the final stages of follicle development. Thereby, determining whether this pathway may be a target for optimisation of IVF treatment and a future treatment option for female infertility.
Comparison of Bone Mineral Density in the Third Trimester Between Women in Singleton and Twin Pregnancies Using Questionnaires and REMS Densitometric Examination
This clinical study aims to monitor and evaluate bone mineral density and fracture risk in women with singleton and twin pregnancies through the combined use of: * two specific questionnaires developed by the Fragility Fracture Observatory (OFF), and * a bone densitometric examination using REMS technology, performed between the 35th and 41st week of gestation. Primary objective: • To identify, in the third trimester of pregnancy (between the 35th and 41st gestational week), any differences in bone mineral density (BMD) between women with singleton pregnancies and women with dichorionic and monochorionic twin pregnancies. Secondary objectives: * Evaluate the relationship between bone mineral density (BMD) values and maternal clinical and historical parameters, such as age, body mass index (BMI), and obstetric and medical history. * Evaluate the association between BMD values and scores obtained from validated questionnaires administered to investigate fracture risk and bone health-related quality of life in women with singleton and twin pregnancies.
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