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Postmenopausal osteoporosis: Factors influencing early treatment with romosozumab

Key clinical point: Early treatment with romosozumab significantly improves bone mineral density (BMD) of the lumbar spine (LS) in postmenopausal osteoporosis. The response is attenuated by previous treatment and predicted by early changes in bone turnover markers.

Major finding: At 6 months of romosozumab induction, the naïve group had the highest increase in LS BMD (13.6%; P less than .001), followed by teriparatide (8.7%; P less than .001), bisphosphonates (7.5%; P less than .001), and denosumab (3.6%; P less than .001) groups. Serum N-terminal type I procollagen propeptide value at baseline and 1 month and isoform 5b of tartrate-resistant acid phosphatase value at baseline and its percentage change at 1 and 6 months were significant predictors (P less than .05) of LS BMD change at 6 months.

Study details: The data come from a prospective, observational, multicenter study of postmenopausal patients with osteoporosis who were either treatment naïve and received romosozumab (n = 37) or were previously treated with bisphosphonates (n = 33), denosumab (n = 45), or teriparatide (n = 15) and switched to romosozumab.

Disclosures: The study received no commercial funding. Dr. Kosuke Ebina and Dr. Ken Nakata are affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho. Dr. Kosuke Ebina, Dr. Makoto Hirao, Dr. Hideki Tsuboi, Dr. Yoshio Nagayama, and Dr. Masafumi Kashii have received research grants from various pharmaceutical companies. The remaining authors reported no conflicts of interest.


Ebina K et al. Bone. 2020 Aug 7. doi: 10.1016/j.bone.2020.115574.