Romosozumab Boosts Bone Density More Than Teriparatide

TOPLINE:

Romosozumab leads to a greater increase in bone mineral density (BMD) than teriparatide in postmenopausal women, with lower discontinuation rates and fewer cardiovascular events.

METHODOLOGY:

• Romosozumab and teriparatide are bone-anabolic agents used for treating osteoporosis, yet studies directly comparing their clinical effects are lacking.
• Researchers conducted a retrospective study of 315 postmenopausal women with osteoporosis treated at an outpatient clinic in Denmark, of whom 162 received romosozumab (mean age, 69.0 years) and 153 received teriparatide (mean age, 69.5 years).
• BMD was measured by dual-energy x-ray absorptiometry at the femoral neck, total hip, and lumbar spine at baseline, 6 months, and 12 months for the romosozumab group and at baseline, 12 months, and 24 months for the teriparatide group.
• The primary endpoint was the percentage change in BMD from baseline to month 12.
• Additional endpoints included fractures during treatment, adverse events (AEs), cardiovascular events, and treatment discontinuations.

TAKEAWAY:

• Compared with teriparatide, romosozumab led to a greater increase in BMD at the femoral neck, total hip, and lumbar spine at 12 months (mean difference of 4.7%, 5.4%, and 4.5%, respectively; P
• Patients treated with romosozumab had lower rates of treatment discontinuation (5.5% vs 32.7%) and cardiovascular events (1.9% vs 6.5%) than those treated with teriparatide.
• Four patients in the romosozumab group and 16 in the teriparatide group experienced new fractures during treatment.
• AEs were more common in those receiving romosozumab, primarily because of injection site reactions, whereas serious AEs were more common among those receiving teriparatide (2.0% vs 0.6%, respectively).

IN PRACTICE:

“In a clinical setting, we found that treatment with [romosozumab] led to faster and larger increases in BMD than treatment with [teriparatide],” the authors wrote. “In addition, the overall risk of AEs was similar between the two treatments, and fewer patients discontinued [romosozumab],” the authors wrote.

SOURCE:

The study, led by Martin C. Hartz, MD, from Aarhus University Hospital in Aarhus, Denmark, was published online in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS:

The small sample size and observational retrospective design limit the generalizability of the findings. The estimates of effect and safety may have been affected as all patients did not complete the entire treatment period. Differences in baseline characteristics between the treatment groups may have influenced the results. 

DISCLOSURES:

No funding source was reported for the study. Some authors reported receiving research grants, lecture fees, and honorarium for advisory boards and lectures from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.