Osteoporosis

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) leads the Federal research effort on osteoporosis. Scientists at universities, medical centers, and other research institutions across the United States who are funded by NIAMS and other National Institutes of Health (NIH) components are pursuing a wide range of basic and clinical studies on the disease.

Significant advances in preventing and treating osteoporosis continue to be made. Such advances are the direct result of research focused on:

• Determining the causes and consequences of bone loss at the cellular and tissue levels.
• Assessing risk factors.
• Developing new strategies to maintain and even enhance bone density and reduce fracture risk.
• Exploring the roles of such factors as genetics, hormones, calcium, vitamin D, drugs, and exercise on bone mass.

Much of the research depends on the willingness of volunteers who take part in clinical trials. Clinical trials are research studies involving people that seek to answer specific scientific questions to find better ways to prevent, detect, or treat diseases.

Some key areas of osteoporosis research supported by the NIAMS and its partners at the NIH are described below.

Genetic Studies

Researchers are continuing to define genetic differences that underlie variation in bone formation, maintenance, and turnover. Applying the findings of genome-wide association studies to identify new molecular pathways related to bone health and disease may lead to new ways to prevent bone loss and fractures.

Bone Cell Biology

Scientists are exploring the biochemical pathways and cellular interactions that underlie the physiology of healthy, damaged, and diseased musculoskeletal tissues. Study of the cells that control bone remodeling continues to yield insights on the underlying causes of osteoporosis and points to possible new therapeutic targets.

Over the past several years, researchers have made considerable progress in understanding connections between bone physiology and the broader network of biologic processes involving many different organs and tissues. Scientists are working to explain the connection between the skeleton and the nervous system; other tissues such as fat, muscle, cartilage; the immune system; digestion and nutrition (including the role of the microbiome); and energy metabolism.

Study of Osteoporotic Fractures

The Study of Osteoporotic Fractures (SOF), which is supported by the NIAMS and the National Institute on Aging (NIA), is a multicenter study of 10,000 postmenopausal Caucasian women that has yielded comprehensive data about multiple risk factors for osteoporosis-related fractures. This study, which began in 1986, has provided the foundation for developing ways to identify people at greatest risk for osteoporosis and fractures decades in advance, and thus has greatly aided disease prevention efforts.

Osteoporosis in Men

Osteoporosis in men has undergone major scrutiny in a multicenter study funded by the NIAMS in partnership with the NIA and the National Cancer Institute. The Osteoporosis in Men study (MrOS) enrolled 6,000 men age 65 years and older, and has identified significant risk factors for osteoporosis, falls, and fractures in men.

Evaluating and Assessing Bone Quality

Scientists are exploring architectural and material factors that influence bone quality in hopes of gaining a better understanding of how properties of bone other than its mass or density affect bone strength. They are also developing new methods to assess bone quality and bone strength and predict fracture risk based on technologies such as ultrasound, computed tomography and magnetic resonance imaging.

Treatments for Osteoporosis

Researchers are examining the molecular and cellular mechanisms by which currently used osteoporosis drugs work, in the hope of advancing knowledge about their application to bone. In other studies, scientists are investigating novel approaches for preventing fractures associated with osteoporosis and related conditions.

Investigators are assessing the potential of combining therapeutic agents to achieve additive or synergistic treatment benefits in people with osteoporosis. As well, studies are comparing the effectiveness of different therapeutic approaches.

Prevention Studies

Researchers continue to explore the impact of nutritional status on bone health and fracture risk. Scientists are examining the impact of physical activity levels on bone health and are developing and testing strategies to promote bone health through exercise and physical rehabilitation programs.
Researchers are also exploring effects of environmental factors, such as smoking and environmental toxins, on skeletal health.

Hope for the Future

With ongoing research, experts hope that osteoporosis will come to be considered a curable disease. Research has enhanced our knowledge about how to maintain a healthy skeleton throughout life and has led to progress in understanding the causes, prevention, diagnosis, and treatment of osteoporosis. Every research advance brings us closer to eliminating the pain and suffering caused by this disease.