Osteoporosis: Pathophysiology and therapeutic options

Ursula Föger-Samwald, Peter Dovjak, Ursula Azizi-Semrad, Katharina Kerschan-Schindl, Peter Pietschmann

Research output: Journal article (peer-reviewed)Review article

126 Citations (Scopus)


Osteoporosis is a metabolic bone disease that, on a cellular level, results from osteoclastic bone resorption not compensated by osteoblastic bone formation. This causes bones to become weak and fragile, thus increasing the risk of fractures. Traditional pathophysiological concepts of osteoporosis focused on endocrine mechanisms such as estrogen or vitamin D deficiency as well as secondary hyperparathyroidism. However, research over the last decades provided exiting new insights into mechanisms contributing to the onset of osteoporosis, which go far beyond this. Selected mechanisms such as interactions between bone and the immune system, the gut microbiome, and cellular senescence are reviewed in this article. Furthermore, an overview on currently available osteoporosis medications including antiresorptive and bone forming drugs is provided and an outlook on potential future treatment options is given.

Original languageEnglish
Pages (from-to)1017-1037
Number of pages21
JournalEXCLI Journal
Publication statusPublished - 2020
Externally publishedYes


  • Gut microbiome
  • Osteoimmunology
  • Osteoporosis
  • Osteoporosis treatment
  • Pathophysiology
  • Senescence

ASJC Scopus subject areas

  • Drug Discovery
  • Molecular Medicine
  • Animal Science and Zoology
  • Pharmacology


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