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In this editorial MedZine highlights two interesting studies on the topic of bone disease. The first describes oral medication for patients with osteogenesis imperfecta. The second elucidates the role of NOX4 in bone metabolism.

Effective oral medication for osteogenesis imperfecta

Osteogenesis imperfecta, or brittle bone disease, is a rare genetic disease that results in fragile bones that break easily. There is no cure for osteogenesis imperfect and treatment is aimed at increasing overall bone strength to prevent fracture and maintain mobility. Children with osteogenesis imperfecta are often treated with intravenous bisphosphonates. In a publication in the Lancet, Bishop and colleagues investigate the effectiveness of oral bisphosphonates. They treated 94 patients with the oral bisphosphonate and 49 with placebo. The bisphosphonate treated group showed increased lumbar spine areal bone mineral density and less clinical fractures. In addition, the drug was well tolerated. Therefore, the researchers conclude that oral bisphosphonate should be regarded as a treatment option for children with osteogenesis imperfecta.

The role of NOX4 in bone metabolism

In a publication in the Journal of Clinical Investigation, Goettsch and colleagues studied the role of NADPH oxidase 4 (NOX4) in bone homeostasis. Altered bone homeostasis is the cause of several conditions, the most abundant being osteoporosis. Nox4 knock-out mice displayed higher bone density and reduced numbers and markers of osteoclasts. Osteoclastogenesis was impaired by loss of NOX4. In a mouse model of ovariectomy–induced osteoporosis, inhibition of NOX4 diminished trabecular bone loss. In addition, the researchers found increased NOX4 expression in human bone obtained from patients with increased osteoclast activity. Thus, NOX4 is involved in bone loss and represents a potential therapeutic target for the treatment of osteoporosis according to the authors.

Sources: The Lancet and The Journal of Clinical Investigation