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Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis.
Osteoporos Int. 2017 10; 28(10):2967-2973.OI

Abstract

Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis.

INTRODUCTION

TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM.

METHODS

Postmenopausal women with lumbar spine or total hip BMD T-score <-2.5 and -4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit.

RESULTS

Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was -2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r 2 ≤ 0.06).

CONCLUSIONS

In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD.

Authors+Show Affiliations

Oregon Osteoporosis Center, Portland, OR, USA. mmcclung.ooc@gmail.com. Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia. mmcclung.ooc@gmail.com.University of Berne, Berne, Switzerland.University of Florence, Florence, Italy.Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina.Michigan Bone and Mineral Clinic, Detroit, MI, USA.INSERM UMR 1033, Université de Lyon, Hôpital Edouard Herriot, Lyon, France.Lausanne University Hospital, Center of Bone Diseases, Lausanne, Switzerland.Amgen Inc., Thousand Oaks, CA, USA.Amgen Inc., Thousand Oaks, CA, USA. Radius Health, Waltham, MA, USA.Amgen Inc., Thousand Oaks, CA, USA. UCB Pharma, Brussels, Belgium.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28748386

Citation

McClung, M R., et al. "Effect of Denosumab On Trabecular Bone Score in Postmenopausal Women With Osteoporosis." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 28, no. 10, 2017, pp. 2967-2973.
McClung MR, Lippuner K, Brandi ML, et al. Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis. Osteoporos Int. 2017;28(10):2967-2973.
McClung, M. R., Lippuner, K., Brandi, M. L., Zanchetta, J. R., Bone, H. G., Chapurlat, R., Hans, D., Wang, A., Zapalowski, C., & Libanati, C. (2017). Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(10), 2967-2973. https://doi.org/10.1007/s00198-017-4140-y
McClung MR, et al. Effect of Denosumab On Trabecular Bone Score in Postmenopausal Women With Osteoporosis. Osteoporos Int. 2017;28(10):2967-2973. PubMed PMID: 28748386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis. AU - McClung,M R, AU - Lippuner,K, AU - Brandi,M L, AU - Zanchetta,J R, AU - Bone,H G, AU - Chapurlat,R, AU - Hans,D, AU - Wang,A, AU - Zapalowski,C, AU - Libanati,C, Y1 - 2017/07/26/ PY - 2017/01/11/received PY - 2017/06/28/accepted PY - 2017/7/28/pubmed PY - 2018/7/26/medline PY - 2017/7/28/entrez KW - Denosumab KW - Postmenopausal women KW - Trabecular bone score SP - 2967 EP - 2973 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 28 IS - 10 N2 - : Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis. INTRODUCTION: TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM. METHODS: Postmenopausal women with lumbar spine or total hip BMD T-score <-2.5 and -4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit. RESULTS: Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was -2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r 2 ≤ 0.06). CONCLUSIONS: In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/28748386/Effect_of_denosumab_on_trabecular_bone_score_in_postmenopausal_women_with_osteoporosis_ L2 - https://doi.org/10.1007/s00198-017-4140-y DB - PRIME DP - Unbound Medicine ER -