Worldwide 200 million women are affected by osteoporosis. In the United States alone, 8 million women and 2 million men have osteoporosis and another 34 million have low bone mass and are at risk of osteoporosis. Osteoporosis is a major burden on the economy, costing more than $13 billion in the U.S. annually.

Osteoporosis is a disease characterized by low bone mass that is of poor structural quality which leads to an increased risk of fracture. These types of fractures often occur after little or no trauma and they lead to increased morbidity, loss of independence, and even death. Hip fracture is the most serious osteoprotic fracture and carries a 1 year mortality rate of 20%. A majority of patients never regain their independence after a hip fracture. Hip fracture rates continue to rise and are estimated to exceed 6 million world wide.

Currently available therapies have modest efficacy in improving bone mass and reducing the risk of vertebral (spine) fractures. They are limited by poor tolerability, poor acceptance by patients, and rather poor efficacy in preventing hip fracture. Recently, agents that increase bone formation (anabolic drugs) are becoming available and hold promise to greatly improve the outcomes of patients with osteoporosis.

Coincident with the development of anabolic drugs there has a been an exponential increase in the understanding of bone physiology and osteoporosis pathogenesis. Based on these new insights, many new drugs with important bone molecular targets are in development. Still much remains to be learned about the causes of osteoporosis and there is great opportunity to develop new therapeutics and interventions for this common disease.