Therapeutic potential of Wnt/β-catenin signaling pathway in osteoporosis: from molecular pathways to future clinical challenges

Osteoporosis represents a significant public health challenge due to its high prevalence, silent progression, and serious clinical consequences, primarily the occurrence of fragility fractures as well as the substantial economic burden it imposes on healthcare systems worldwide. Despite the availability of pharmacological treatments, current therapeutic approaches face limitations such as adverse events, suboptimal long-term efficacy, and poor patient adherence. A comprehensive understanding of the pathophysiology of osteoporosis, particularly the molecular and cellular mechanisms governing bone remodeling, is essential for the development of innovative and more effective interventions. By controlling osteoblast differentiation and bone production, the Wnt/β-catenin signaling pathway serves as a key regulator of bone remodeling. This review brings together current understanding of the molecular processes underlying Wnt/β-catenin signaling in bone biology, evaluates emerging therapeutic strategies that target this pathway, and highlights the clinical challenges associated with osteoporosis management.