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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe 2 currently available categories of osteoporosis therapies are the antiresorptive agents, which decrease bone resorption and bone formation, and parathyroid hormone agonists, which increase bone formation and bone resorption. Cathepsin K inhibition is a new mechanism of action that inhibits bone resorption while preserving bone formation.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eanabolic\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ebone formation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ebone remodeling\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ebone resorption\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecathepsin K\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eosteoporosis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eparathyroid hormone\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eparathyroid hormone-related protein\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epostmenopausal\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ERANKL\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Esclerostin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehormone therapy\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EThe parathyroid hormone (1-34) [PTH(1-34)], teriparatide, is the only anabolic agent approved in the United States. PTH(1-34) stimulates bone formation, but it also stimulates bone resorption, limiting its anabolic effect. Teriparatide reduces fractures and increases bone mineral density (BMD) but is associated with hypercalcemia and hypercalciuria.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EAccording to Mara J. Horwitz, MD, University of Pittsburgh, Pittsburgh, Pennsylvania, USA, in phase 1 studies, parathyroid hormone\u2013related protein (1-36) [PTHrP(1-36)] increased markers of bone formation but had little effect on bone resorption and did not cause hypercalcemia. The phase 2 PrOP study randomized 105 postmenopausal women to PTHrP(1-36), 400 mg\/d; PTHrP(1-36), 600 mg\/d; or PTH(1-34), 20 mg\/d [Horwitz MJ et al. \u003Cem\u003EJ Bone Miner Res\u003C\/em\u003E. 2013]. There was a very early significant increase in aminoterminal propeptide of procollagen 1 (P1NP), a marker of bone formation, in all 3 groups, but by day 90, the increase in the PTH(1-34) group was significantly greater than in the PTHrP(1-36) groups. The increase in the bone resorption marker carboxyterminal telopeptides of collagen 1 (CTX) was delayed, with an increase in the PTH(1-34) group at day 60 and the PTHrP(1-36) groups at day 90 (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/4\/19\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022PrOP Study: Change From Baseline in P1NP and CTXCTX, carboxy-terminal telopeptides of collagen 1; P1NP, amino-terminal telopeptides of procollagen 1.*P\u0026#x2005;\u0026amp;lt;\u0026#x2005;.0005#P\u0026#x2005;\u0026amp;lt;\u0026#x2005;.005\u0026#x2020;P\u0026#x2005;\u0026amp;lt;\u0026#x2005;.05Reprinted from J Bone Miner Res, Horowitz MJ et al, A comparison of parathyroid hormone-related protein (1-36) and parathyroid hormone (1-34) on markers of bone turnover and bone density in postmenopausal women: The PrOP study, 2013;28(11):2266-2276, Copyright \u0026#xA9; with permission from American Society for Bone and Mineral Research.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1405856751\u0022 data-figure-caption=\u0022\u0026amp;lt;div xmlns=\u0026amp;quot;http:\/\/www.w3.org\/1999\/xhtml\u0026amp;quot;\u0026amp;gt;PrOP Study: Change From Baseline in P1NP and CTXCTX, carboxy-terminal telopeptides of collagen 1; P1NP, amino-terminal telopeptides of procollagen 1.*\u0026amp;lt;em\u0026amp;gt;P\u0026amp;lt;\/em\u0026amp;gt;\u0026#x2005;\u0026amp;amp;lt;\u0026#x2005;.0005#\u0026amp;lt;em\u0026amp;gt;P\u0026amp;lt;\/em\u0026amp;gt;\u0026#x2005;\u0026amp;amp;lt;\u0026#x2005;.005\u0026#x2020;\u0026amp;lt;em\u0026amp;gt;P\u0026amp;lt;\/em\u0026amp;gt;\u0026#x2005;\u0026amp;amp;lt;\u0026#x2005;.05Reprinted from \u0026amp;lt;em\u0026amp;gt;J Bone Miner Res\u0026amp;lt;\/em\u0026amp;gt;, Horowitz MJ et al, A comparison of parathyroid hormone-related protein (1-36) and parathyroid hormone (1-34) on markers of bone turnover and bone density in postmenopausal women: The PrOP study, 2013;28(11):2266-2276, Copyright \u0026#xA9; with permission from American Society for Bone and Mineral Research.\u0026amp;lt;\/div\u0026amp;gt;\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/4\/19\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/4\/19\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/4\/19\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16524\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-4\u0022 class=\u0022first-child\u0022\u003EPrOP Study: Change From Baseline in P1NP and CTX\u003C\/p\u003E\n               \u003Cp id=\u0022p-5\u0022\u003ECTX, carboxy-terminal telopeptides of collagen 1; P1NP, amino-terminal telopeptides of procollagen 1.\u003C\/p\u003E\n               \u003Cp id=\u0022p-6\u0022\u003E*\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0005\u003C\/p\u003E\n               \u003Cp id=\u0022p-7\u0022\u003E#\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.005\u003C\/p\u003E\n               \u003Cp id=\u0022p-8\u0022\u003E\u2020\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.05\u003C\/p\u003E\n               \u003Cp id=\u0022p-9\u0022\u003EReprinted from \u003Cem\u003EJ Bone Miner Res\u003C\/em\u003E, Horowitz MJ et al, A comparison of parathyroid hormone-related protein (1-36) and parathyroid hormone (1-34) on markers of bone turnover and bone density in postmenopausal women: The PrOP study, 2013;28(11):2266-2276, Copyright \u00a9 with permission from American Society for Bone and Mineral Research.\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-10\u0022\u003ELumbar spine (LS) BMD increased significantly in all 3 groups (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.05). The increase in total hip (TH) and femoral neck (FN) BMD was equivalent in each group but was significant only in both PTHrP(1-36) groups for TH (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.05) and in the PTHrP(1-36)\u2013400 mg group for the FN (all \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.05). On day 90, all groups had the same basal total serum calcium and a small but significant total serum calcium increase 3 to 6 hours postdose (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0005), with no difference between the groups. Hypercalcemia occurred in 10 patients receiving PTHrP(1-36)\u2013400 mg, in 8 receiving PTHrP(1-36)\u2013600 mg, and in none receiving PTH(1-34). This study showed that PTHrP(1-36) and PTH(1-34) stimulate bone formation (P1NP) by day 15, with a later and less robust increase in bone resorption (CTX) compared to PTH(1-34).\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EAbaloparatide, a synthetic peptide analog of PTHrP(1-34), has anabolic activity with less of an increase in bone resorption than PTH(1-34) and less calcium-mobilizing potential. Results of 2 important abaloparatide trials are summarized in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16525\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16525\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16525\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003EStudies of Abaloparatide in Postmenopausal Women With Osteoporosis\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-14\u0022\u003EPTHrP(1-36) and abaloparatide both have anabolic effects on the LS and TH. Both agents are comparable to teriparatide for increasing LS, FN, and TH bone density. Further testing of PTHrP(1-36) is needed to determine the ideal dosage and its clinical benefits. Abaloparatide led to significant reductions in vertebral and nonvertebral fractures that were at least equivalent to teriparatide, with smaller changes in bone turnover. At 80 mg\/d, abaloparatide appears to be safe and well tolerated.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EJacques P. Brown, MD, Laval University, Quebec City, Quebec, Canada, reviewed the available data for romosozumab and blosozumab, humanized monoclonal sclerostin antibodies. Sclerostin is a glycoprotein produced in osteocytes that inhibits bone formation.\u003C\/p\u003E\n         \u003Cp id=\u0022p-16\u0022\u003ERomosozumab is an IgG2 monoclonal antibody with a high affinity for human sclerostin. In animal studies, romosozumab increased bone formation, BMD, and bone strength [Li X et al. \u003Cem\u003EJ Bone Miner Res\u003C\/em\u003E. 2010]. Blosozumab is a humanized IgA antisclerostin monoclonal antibody that has neutralized sclerostin activity in animal studies and a high affinity for human sclerostin. In preclinical studies, blosozumab promoted bone formation and improved bone structure and strength. Phase 1 and 2 trials of romosozumab and blosozumab are summarized in \u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E. In these studies, both romosozumab and blosozumab improved BMD in postmenopausal women with low BMD.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16526\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16526\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16526\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-17\u0022 class=\u0022first-child\u0022\u003EStudies of Antisclerostin Monoclonal Antibodies in Postmenopausal Women\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-19\u0022\u003EA newer antisclerostin monoclonal antibody, BPS804, was evaluated in a 9-month multiple-dose study in postmenopausal women with low BMD. The study was completed in October 2013, but no results have been published.\u003C\/p\u003E\n         \u003Cp id=\u0022p-20\u0022\u003EIn summary, the high-affinity humanized sclerostin monoclonal antibodies are currently under evaluation as bone anabolic agents for the treatment of osteoporosis in postmenopausal women. The preliminary results of surrogate end points such as BMD and bone markers are promising and associated with a good safety profile. Antifracture efficacy data should be available soon for romosozumab. Further studies are needed to integrate this new treatment option within current osteoporosis therapies.\u003C\/p\u003E\n         \u003Cp id=\u0022p-21\u0022\u003EMichael R. McClung, MD, Oregon Osteoporosis Center, Portland, Oregon, USA, focused on the osteoclast-osteoblast coupling mechanism to demonstrate the different effects of receptor-activated nuclear factor \u03baB ligand (RANKL) and cathepsin K inhibition on bone remodeling. Coupled bone remodeling involves communication between osteoblasts and osteoclasts via the RANKL pathway [Sims NA, Martin TJ. \u003Cem\u003EBonekey Rep\u003C\/em\u003E. 2014]. RANKL is a growth-promoting factor secreted by osteoblasts that binds to its receptor, RANK, on preosteoclasts, resulting in differentiation and proliferation of osteoclasts. Osteoclasts modulate osteoblast activity by releasing regulatory factors from bone matrix during bone resorption. The RANKL inhibitor, denosumab, causes a marked decrease in osteoclasts, resulting in reduced bone resorption, followed by a substantial decrease in bone formation.\u003C\/p\u003E\n         \u003Cp id=\u0022p-22\u0022\u003ECathepsin K, a specialized enzyme highly expressed in osteoclasts, is the main proteolytic enzyme that degrades proteins in bone matrix. Cathepsin K inhibition results in decreased bone resorption but osteoclast number and function are not decreased and may increase, resulting in no change in or increased bone formation. Odanacatib is a highly selective, reversible, and potent inhibitor of cathepsin K [Duong LT. \u003Cem\u003EBonekey Rep\u003C\/em\u003E. 2012; Leung P et al. \u003Cem\u003EBone\u003C\/em\u003E. 2011]. In a phase 2 study, odanacatib administered for 5 years to postmenopausal women with low BMD reduced markers of bone resorption, while bone formation markers fell at the outset of treatments but returned to baseline after 2 years. As a consequence, progressive increases in spine and hip BMD were observed [Langdahl B et al. \u003Cem\u003EJ Bone Miner Res\u003C\/em\u003E. 2012].\u003C\/p\u003E\n         \u003Cp id=\u0022p-23\u0022\u003EThe just-completed phase 3 LOFT trial [McClung MR et al. ASBMR 2014 (abstr 1147)] of odanacatib in 16\u2005000 postmenopausal women with osteoporosis was stopped at the first interim analysis because of robust efficacy. The trial design has been published [Bone HG et al. \u003Cem\u003EOsteoporos Int.\u003C\/em\u003E 2015], but unpublished results show that over about 3 years, odanacatib reduced vertebral fractures by 54%, hip fractures by 47%, and clinical vertebral fractures by 72%. The longer patients were on therapy, the greater the apparent reduction in nonvertebral fracture risk.\u003C\/p\u003E\n         \u003Cp id=\u0022p-24\u0022\u003E\n            \u003Ca id=\u0022xref-table-wrap-3-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T3\u0022\u003ETable 3\u003C\/a\u003E compares the effects of RANKL (denosumab) and cathepsin K (odanacatib) inhibition.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T3\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16527\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16527\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16527\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 3.\u003C\/span\u003E \n               \u003Cp id=\u0022p-25\u0022 class=\u0022first-child\u0022\u003EComparison of Effects of RANKL Inhibition and Cathepsin K Inhibition\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-28\u0022\u003ECathepsin K inhibition is a potential new therapy for osteoporosis with a unique mechanism of action that inhibits bone resorption but preserves osteoclast function and bone formation. Dr McClung concluded that odanacatib promises to be a useful and important addition to treatment options for osteoporosis.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/4\/19.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzln31\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzln31\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzln31\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}