Maintenance therapy for added bone mass or how to keep the profit after withdrawal of therapy of osteopenia

Since continuous therapy for osteoporosis can be expensive and may have detrimental effects, there is a need to develop a strategy to maintain bone mass after withdrawal of treatment. The bone maintained by estrogen and calcitonin therapies and exercise, but the added bone induced by anabolic agents disappears upon cessation of treatment. To avoid this pitfall, the concepts of activation, restore and maintain (ARM) or loss, restore and maintain (LRM), the on/off administration of combined anabolic agent with an antiresorptive or antiactivation agent, and cyclical treatment of the two regimes have been employed successfully in “keeping the profit” (maintaining bone) in preclinical studies. The data for the disappearance of bone upon cessation of certain osteopenic treatments, its mechanism of loss and the development of maintenance concept and subsequent preclinical studies indicate that there was no need for costly continuous therapy in the treatment strategy for osteoporosis.