COMPARISON BETWEEN ANABOLIC AND ANTIRESORPTIVE THERAPIES IN OSTEOPOROSIS: ANTIFRACTURE EFFICACY AND THERAPEUTIC STRATEGY

Abstract

Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density and deterioration of bone microarchitecture, which significantly increases the risk of fragility fractures. In this context, different pharmacological approaches have been used in the treatment of the disease, particularly antiresorptive and anabolic therapies. The present study aimed to compare the antifracture efficacy of these therapies and discuss their implications for therapeutic planning in patients with osteoporosis. This study is an integrative literature review conducted using the PubMed/MEDLINE, SciELO, and ScienceDirect databases. Articles published between 2016 and 2026, available in full text in Portuguese or English, addressing the effectiveness of anabolic and antiresorptive therapies in preventing osteoporotic fractures were included. After applying the inclusion and exclusion criteria, 15 scientific studies were selected to compose the final sample of the review. The results indicated that antiresorptive therapies remain widely used as first-line treatment due to their proven effectiveness in reducing the risk of vertebral, non-vertebral, and hip fractures. On the other hand, anabolic therapies have shown significant benefits in patients with severe osteoporosis or at high fracture risk, promoting greater increases in bone mineral density. In addition, recent evidence suggests that sequential therapeutic strategies, involving initial use of anabolic agents followed by antiresorptive drugs, may provide better clinical outcomes. It is concluded that both therapeutic classes play an important role in the management of osteoporosis, highlighting the importance of individualized treatment according to each patient's clinical profile and fracture risk.