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Romosozumab following denosumab improves lumbar spine bone mineral density and trabecular bone score greater than denosumab continuation in postmenopausal women

Authors
 Namki Hong  ;  Sungjae Shin  ;  Hyunjae Kim  ;  Sung Joon Cho  ;  Jin Ah Park  ;  Yumie Rhee 
Citation
 JOURNAL OF BONE AND MINERAL RESEARCH, Vol.40(2) : 184-192, 2025-02 
Journal Title
JOURNAL OF BONE AND MINERAL RESEARCH
ISSN
 0884-0431 
Issue Date
2025-02
MeSH
Aged ; Antibodies, Monoclonal* / pharmacology ; Bone Density* / drug effects ; Cancellous Bone* / drug effects ; Cancellous Bone* / metabolism ; Denosumab* / pharmacology ; Denosumab* / therapeutic use ; Female ; Humans ; Lumbar Vertebrae* / drug effects ; Lumbar Vertebrae* / metabolism ; Middle Aged ; Postmenopause* / drug effects
Keywords
DXA ; anabolics ; antiresorptives ; fracture prevention ; osteoporosis
Abstract
Romosozumab following anti-resorptive can be an effective sequential treatment strategy to improve bone strength. However, whether the transition to romosozumab after denosumab is associated with greater improvement in bone mineral density (BMD) and trabecular bone score (TBS) compared with denosumab continuation remains unclear. In this propensity score-matched cohort study, we analyzed data from postmenopausal women who initiated denosumab between 2017 and 2020. Individuals who were transited to 12 mo of romosozumab after denosumab were 1:1 matched to those who continued an additional 12 mo of denosumab (n = 86 for each group; denosumab-romosozumab [DR] and denosumab-denosumab [DD]). Mean BMD gain by denosumab treatment in matched DR and DD groups from denosumab initiation to transition (median 4 times [range 2-8]) was +4.8% and +2.0% in the lumbar spine (LS) and total hip, respectively. DR group showed greater LS BMD gain compared with the DD group (+6.8 vs +3.3% point, p<.001) for 12 mo post-transition independent of the duration of prior denosumab treatment, yielding greater overall LS BMD gain in DR compared with DD (+11.6% vs +8.0%, p<.001). DD group showed continued improvement of hip BMD, whereas hip BMD was maintained but not improved in the DR group. DR group was associated with greater TBS improvement than the DD group (2.9% vs 1.0%, p = .042). One month after the transition to romosozumab from denosumab, P1NP immediately increased above the level of denosumab initiation with relatively suppressed CTx, creating a transient anabolic window. For 12 mo follow-up, 1 incident morphometric vertebral fracture and 1 patella fracture were observed in DD, whereas 1 ankle fracture was observed in the DR group. Romosozumab following denosumab improved LS BMD and TBS greater than denosumab continuation in postmenopausal women.
Full Text
https://academic.oup.com/jbmr/article/40/2/184/7863360?login=true
DOI
10.1093/jbmr/zjae179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Rhee, Yumie(이유미) ORCID logo https://orcid.org/0000-0003-4227-5638
Hong, Nam Ki(홍남기) ORCID logo https://orcid.org/0000-0002-8246-1956
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/205292
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