Dual Targeting Anti-Osteoporotic Therapy Through Potential Nanotherapeutic Approaches.

Osteoporosis is characterised by a major public health burden, particularly taking into account the ageing global population. Therapeutic modalities for osteoporosis are categorised on the basis of their effect on bone remodeling: antiresorptive and anabolic agents. Anabolic drugs are favoured as they promote the formation of new bone, whereas antiresorptive drugs terminate the further deterioration of bone. Non-specific delivery of anabolic agents results in prolonged kidney exposure causing malignant hypercalcemia, whereas antiresorptive agents and bisphosphonates may produce osteonecrosis of the jaw. Several clinical trials have been reported for combinational therapy of anabolic agents and antiresorptive agents for osteoporosis. However, none of them have proven their cumulative effects in the treatment of disease. The present work emphasizes a dualtargeting drug delivery approach comprising of bone anabolic and antiresorptive agents that would simultaneously deliver the therapeutic agents to both the zones of bone. The anticipated pioneering delivery approach will intensify the explicit interaction between the therapeutic agent and bone surfaces separately without developing severe adverse effects and improve osteoporotic therapy effectively compared to non-targeted drug delivery.