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Risedronate + teriparatide is a combination therapy investigated by researchers at Columbia University for the treatment of male osteoporosis. Risedronate is a third-generation pyridinyl bisphosphonate that acts as an antiresorptive agent by inhibiting farnesyl pyrophosphate synthase (FPPS) in the mevalonate pathway, which leads to the inhibition of osteoclast-mediated bone resorption and induces osteoclast apoptosis. Teriparatide is a recombinant form of human parathyroid hormone (residues 1-34) that acts as an anabolic agent, stimulating new bone formation by increasing the number and activity of osteoblasts through the activation of the parathyroid hormone receptor 1 (PTH1R). The combination therapy is designed to leverage both antiresorptive and anabolic mechanisms to increase bone mineral density (BMD) more effectively than monotherapy with either agent alone. A Phase 3 trial (the RPM study) conducted at Columbia University's Metabolic Bone Diseases Unit demonstrated that the combination significantly increased BMD at the lumbar spine and hip in men with low bone density.
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