Anabolic bone agents (teriparatide, romosozumab), SERMs and menopausal hormone therapy for bone
Why intermittent PTH builds bone while continuous PTH destroys it, how teriparatide, abaloparatide and romosozumab differ, why an anabolic must be followed by an antiresorptive and why the order matters, and how raloxifene and menopausal hormone therapy protect bone through oestrogen receptor signalling.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Anabolic agents build new bone: teriparatide (PTH 1-34), abaloparatide (PTHrP analogue) and romosozumab (anti-sclerostin).
- Oestrogen-receptor drugs slow resorption: raloxifene (a SERM) and menopausal hormone therapy (MHT).
- Paper 1 asks why the timing of PTH exposure decides its effect, how romosozumab works on both sides of remodelling, why sequence matters, and which tissues SERMs block or stimulate.
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Sources
- 2024 RACGP and Healthy Bones Australia guideline for osteoporosis management and fracture prevention in postmenopausal women and men over 50AU/NZMedical Journal of Australia 2025;222(9), 2024
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd, 2026
- New treatment announced on PBS (abaloparatide)AU/NZHealthy Bones Australia, 2026
- Pharmacological management of osteoporosis in postmenopausal women: an Endocrine Society guideline updateShoback et al., J Clin Endocrinol Metab 2020;105:587-94, 2020
- Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosisNeer et al., N Engl J Med 2001;344:1434-41, 2001
- Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO)Kendler et al., Lancet 2018;391:230-40, 2018
- Romosozumab or alendronate for fracture prevention in women with osteoporosis (ARCH)Saag et al., N Engl J Med 2017;377:1417-27, 2017
- Effect of abaloparatide vs placebo on new vertebral fractures in postmenopausal women with osteoporosis (ACTIVE)Miller et al., JAMA 2016;316:722-33, 2016
- Last updated
- 14 November 2026
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