Selective Androgen Receptor Modulators (SARMS)
No SARMS are on the market at this time for clinical use. The pharmaceutical companies are working on developing them with an eye to the bone market and markets in oncology (cancer cachexia), AIDS (wasting syndrome), general aging (sarcopenia), and perhaps the cardiovascular health.
Merck was working on a medicine called enobosarm (Ostarine) but they abandoned it after poor clinical trials results. Another, smaller company (GTX) is still pursuing it and in Phase II trials. Bristol-Myers Squib, Ligand Pharmaceuticals, Kaken Pharmaceuticals, Acadia Pharmaceuticals are attempting to develop SARMs.A non-steroidal SARM called LGD-4033 has shown promise in increaseing body weight in tests. Imidazolopyrazole is another SARM under development, although at a preclinical stage and the developer seems interested in other uses than bone health. So far it has been found to have muscle-building effects with no red flag side effects. Eli Lilly has LY2452473 in very early development. The diuretic Aldactone (Spironolactone) has been used for years and it might have some SARM activity. Japanese researchers have investigated S-101479 for bone building and found it might have additive effects with other osteoporosis medicines. The SARM LGD-4033 has been found to promote increases in lean body mass without an increase in prostate problem markers, although the research study did not specifically look at the effect on bone density.
If SARMs do enter clinical use, there is a good chance doctors will prescribe them in combination with bisphosphonates. Because the two drugs work differently and approach the loss of bone from different metabolic directions (bisphosphonates stop osteoclastic destruction, SARMs increase bone formation), the combination will hit the osteoporosis with a "one-two punch". Research in rats found that the combination of a bisphosphonate and a SARM had a synergistic effect on osteoporosis.
Likewise, research tests have shown the SARM S-101479 in combination with a bisphosphonate has bone-building effects in laboratory animals.
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