Which osteoporosis medication works by preferentially stimulating activity of osteoblasts?

The choice that preferentially stimulates the activity of osteoblasts is Teriparatide. Teriparatide is a recombinant form of parathyroid hormone (PTH) that works by increasing bone formation. It does this by specifically stimulating osteoblast activity, which leads to an increase in the production of new bone. This anabolic effect is particularly beneficial in treating osteoporosis, as it can help to increase bone mineral density and reduce the risk of fractures.

In contrast, other osteoporosis medications operate through different mechanisms. For example, Denosumab is a monoclonal antibody that inhibits RANKL, a key protein involved in the activation of osteoclasts, thereby reducing bone resorption rather than promoting bone formation. Ibandronate is a bisphosphonate that primarily inhibits osteoclast-mediated bone resorption, leading to a net reduction in bone turnover, but it does not stimulate osteoblasts. Raloxifene is a selective estrogen receptor modulator (SERM) that has estrogen-like effects on bone, but it also does not directly stimulate osteoblast activity.

Thus, Teriparatide stands out as the medication that directly engages and stimulates osteoblasts to promote bone formation, addressing the core treatment goal in osteoporosis management