Silva, Barbara C.; Costa, Aline G.; Cusano, Natalie E.; Bilezikian, John P.
In this review, we consider new concepts in the assessment of fracture risk and pharmacologic therapy for osteoporosis. We discuss trabecular bone score, a new imaging technology that adds information that cannot be obtained by only measuring bone mineral density by dual-energy x-ray absorptiometry. We also discuss innovations in antiresorptive, osteoanabolic, and combination therapy, and newer therapeutic classes, including cathepsin K inhibitors and antisclerostin antibodies. We do not cover agents that have not yet been studied in human clinical trials or that are no longer under active investigation.