Osteoporosis affects over 3 million people in the UK, causing more than 500,000 fractures annually. The condition costs the NHS approximately £4.4 billion per year. While bisphosphonates have been the backbone of treatment for 25 years, a new generation of therapies — including bone-building anabolic agents and ultra-long-acting injections — is expanding options dramatically. Here is what is actively recruiting in the UK right now.
The UK has one of the world's most advanced osteoporosis research ecosystems. The Royal Osteoporosis Society (ROS), NIHR musculoskeletal clinical research networks, and the Fracture Liaison Service (FLS) model — pioneered in the UK — provide an unparalleled infrastructure for clinical trials.
Currently, there are over 70 actively recruiting osteoporosis trials in the UK. The field is moving from "one size fits all" bisphosphonate treatment to a personalised approach based on fracture risk, bone density, turnover markers, and treatment sequencing.
Types of Osteoporosis Trials
Anabolic Agents
Bone-building therapies that stimulate new bone formation — teriparatide, abaloparatide, romosozumab — for patients at highest fracture risk.
Anti-Resorptives
Next-generation bisphosphonates, denosumab innovations, and novel cathepsin K inhibitors that slow bone loss.
Treatment Sequencing
Optimal order of therapies — when to start, when to switch, how to prevent rebound fractures after stopping treatment.
Fracture Prevention
Post-fracture care pathways, fall prevention, and secondary prevention strategies including FLS-linked interventions.
Anabolic Bone-Building Therapies
Anabolic agents actually build new bone rather than just slowing loss — making them the most powerful tools for patients with severe osteoporosis or recent fractures:
Teriparatide (Forsteo) — a daily injection of parathyroid hormone analogue, already approved. Current trials explore longer treatment durations and combination with anti-resorptives
Abaloparatide — a newer PTHrP analogue that may build bone with less hypercalcaemia risk than teriparatide. UK trials are comparing it head-to-head with existing anabolics
Romosozumab (Evenity) — the first sclerostin inhibitor, a monthly injection that both builds bone and reduces bone loss simultaneously (covered in detail below)
Romosozumab and Sclerostin Inhibition
Romosozumab represents the most significant advance in osteoporosis treatment in a decade. By blocking sclerostin — a protein that naturally inhibits bone formation — it unlocks the body's bone-building capacity:
Rapid BMD gains — increases bone mineral density at the lumbar spine by 15% in 12 months, more than any other therapy
Dual mechanism — increases bone formation while simultaneously decreasing bone resorption
Severe osteoporosis populations — UK trials are testing romosozumab in patients with very high fracture risk, including those with multiple prior fractures
Sequencing after romosozumab — trials determining the optimal anti-resorptive to follow romosozumab with, to maintain BMD gains
Cardiovascular safety — ongoing studies addressing the cardiovascular signals seen in earlier trials
Anti-Resorptive Innovations
While anabolic agents build bone, anti-resorptives remain essential for maintaining it. Innovation continues:
Denosumab biosimilars — with Prolia's patent approaching expiry, biosimilar trials are opening in the UK, potentially reducing costs significantly
Ultra-long-acting bisphosphonates — extended-interval zoledronic acid and novel formulations requiring less frequent dosing
Odanacatib and cathepsin K inhibitors — newer approaches to blocking bone breakdown through different pathways
Oral alternatives — improved oral formulations with better absorption and fewer gastrointestinal side effects
Fracture Prevention and Treatment Sequencing
The UK has pioneered the Fracture Liaison Service model, which identifies patients after a fracture and initiates osteoporosis treatment. Current trials are optimising this approach:
FLS-linked clinical trials — embedding research into the post-fracture care pathway, making trial participation easier for patients
Treatment holidays — determining which patients can safely stop bisphosphonates after 3–5 years without rebound fracture risk
Rebound vertebral fractures — trials addressing the cluster of vertebral fractures seen after stopping denosumab, and how to prevent them
Anabolic-first approach — whether starting with bone-building therapy followed by anti-resorptive maintenance produces better outcomes
Secondary Osteoporosis and Special Populations
Not all osteoporosis is age-related. UK trials are addressing secondary causes and special populations:
Glucocorticoid-induced osteoporosis — trials in patients on long-term steroids (for RA, asthma, COPD, and other conditions)
Cancer treatment-related bone loss — androgen deprivation therapy (prostate cancer), aromatase inhibitor therapy (breast cancer)
Post-transplant osteoporosis — bone protection for organ transplant recipients on immunosuppression
Male osteoporosis — historically under-researched, with dedicated trials now opening for men with low bone density
Young adults with osteoporosis — genetic forms, idiopathic juvenile osteoporosis, and premature ovarian insufficiency
Who Can Participate?
Common eligibility criteria for UK osteoporosis trials include:
Confirmed osteoporosis by DEXA scan (T-score ≤ -2.5) or a recent fragility fracture
Fracture history — some trials require ≥1 vertebral or hip fracture; others accept any fragility fracture
Bone turnover markers — some trials use CTX, P1NP, or other markers to stratify patients
Previous treatment — some trials require bisphosphonate-naïve status; others require failure of prior therapy
Vitamin D levels — adequate vitamin D (typically ≥20 ng/mL) is often required, with supplementation provided if needed
Age and menopausal status — most postmenopausal trials accept women 45+; male trials accept men 50+
Renal function — eGFR ≥30 or ≥35 for most trials (bisphosphonates are contraindicated in severe renal impairment)
💡 Tip: Request Your DEXA Results and FRAX Score
Before searching for osteoporosis trials, obtain your most recent DEXA scan results (T-scores for lumbar spine, hip, and forearm), any fracture history with dates, and your current calcium/vitamin D supplementation. If your GP has calculated a FRAX score (10-year fracture risk), that is also valuable for trial eligibility assessment.
UK Osteoporosis Trial Locations
Major UK centres running osteoporosis trials include:
Sheffield — Sheffield Teaching Hospitals, one of the UK's leading metabolic bone disease centres
Glasgow — Queen Elizabeth University Hospital, Glasgow Royal Infirmary
London — Royal London Hospital, Guy's and St Thomas', King's College Hospital
Birmingham — University Hospitals Birmingham, Royal Orthopaedic Hospital
Manchester — Manchester Royal Infirmary, Salford Royal
Edinburgh — Royal Infirmary of Edinburgh, Western General Hospital
Cardiff — University Hospital of Wales, Cardiff University Bone Research Unit
Aberdeen — Aberdeen Royal Infirmary, University of Aberdeen musculoskeletal research
How to Find Your Match
Use our Smart Matcher to find osteoporosis trials tailored to your bone density, fracture history, and treatment background. Whether you have recently been diagnosed, experienced a fracture, or need a change in treatment, we can match you to actively recruiting studies.