Romosozumab Boosts BMD, More in Treatment-Naive Patients

TOPLINE:

Romosozumab increases the bone mineral density (BMD) in patients with osteoporosis, according to a study which also suggests that treatment-naive patients show greater BMD gains than patients who had previous treatments.

METHODOLOGY:

• Researchers evaluated 99 patients (92 women; median age, 71 years) from a Swiss Osteoporosis Registry between 2021 and 2023, who received romosozumab (210 μg monthly) for 11-12 months.
• A total of 22 patients were treatment-naive and 77 had received antiresorptive therapy.
• BMD and concentrations of bone turnover markers (C-terminal telopeptide of type I collagen [CTX] and/or N-terminal propeptide of type 1 procollagen) were measured at the lumbar spine, total hip, and femoral neck before and after romosozumab treatment.
• The primary outcome was the difference in BMD (g/cm²) after romosozumab treatment.

TAKEAWAY:

• Romosozumab led to a 10.3% increase in BMD at the lumbar spine, 3.1% increase in BMD at the total hip, and 3.1% increase in BMD at the femoral neck over 12 months.
• The pretreated patients showed significantly lower BMD responses (10.1% at the lumbar spine, 2.9% at the total hip, and 2.0% at the femoral neck) than the treatment-naive patients (P = .05, P = .02, and P < .001, respectively).
• The prior antiresorptive therapy duration was inversely associated with an increase in BMD.
• The body mass index, T-scores, baseline CTX levels, and duration of prior antiresorptive therapy showed a significant association with changes in BMD.

IN PRACTICE:

“We conclude that prior antiresorptive therapy, particularly the long-term administration of bisphosphonates, blunted the BMD response to romosozumab, and the duration correlated with changes at both the lumbar spine and total hip,” the authors wrote.

SOURCE:

The study was led by Judith Everts-Graber, University Hospital Bern and University of Bern, Bern, Switzerland. It was published online on June 26, 2024, in Osteoporosis International.

LIMITATIONS:

The study’s observational nature and relatively small sample size may limit the generalizability of its findings. The partial lack of information on bone turnover markers during romosozumab therapy could affect the reliability of the results. The treatment-naive patients demonstrated lower T-scores than the pretreated patients, potentially overestimating the percentage BMD gains.

DISCLOSURES:

The study was supported by the University of Bern, OsteoRheuma Bern AG, and Swiss Osteoporosis Registry Association. Seven authors reported having ties with various pharmaceutical companies. The other authors declared no conflicts of interest.