Impact of prior teriparatide treatment on the effectiveness of romosozumab in patients with postmenopausal osteoporosis: A case-control study.

Bone Pub Date : 2025-01-04 DOI:10.1016/j.bone.2025.117389

Kosuke Ebina, Tomonori Kobayakawa, Yuki Etani, Takaaki Noguchi, Masafumi Kashii, Gensuke Okamura, Yoshio Nagayama, Hideki Tsuboi, Akira Miyama, Makoto Hirao, Yuji Fukuda, Takuya Kurihara, Atsushi Sugimoto, Ken Nakata, Seiji Okada

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Abstract

Purpose: To evaluate the impact of prior teriparatide (TPTD) treatment on the effectiveness of romosozumab (ROMO) in postmenopausal osteoporosis.

Methods: In this retrospective, case-controlled, multicenter study, 323 postmenopausal patients were initiated ROMO. Of these, 275 were treatment-naïve, and 48 were switched from TPTD, with uninterrupted ROMO treatment for 12 months. Propensity score matching was applied to ensure clinical comparability, yielding 44 patients in each group. Baseline characteristics included a mean age of 78.0 years, lumbar spine (LS) T-score of -3.6, and total hip (TH) T-score of -2.8. Bone mineral density (BMD) and serum bone turnover markers were evaluated over the 12-month period.

Results: The increasing rate in the bone formation marker PINP was significantly greater in the treatment-naïve group compared to the TPTD-switched group throughout the 1-12 month period. Conversely, the reduction in the bone resorption marker TRACP-5b was similar between the groups, indicating a diminished anabolic window in the TPTD-switched group. After 12 months, the TPTD-switched group showed lower BMD gains in the LS (10.3 % vs. 17.3 %; P = 0.002) and TH (3.1 % vs. 7.8 %; P = 0.002) compared to the treatment-naïve group. Multiple regression analysis revealed positive associations between the 12-month percentage BMD increases (LS; β = 0.30; 95 % CI = 0.85-11.61; P = 0.024 / TH; β = 0.32; 95 % CI = 0.51-8.56; P = 0.028) and being treatment-naïve compared to prior TPTD treatment.

Conclusions: Prior TPTD treatment may attenuate the effectiveness of ROMO, potentially due to diminished bone formation activation.

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既往特立帕肽治疗对绝经后骨质疏松患者romosozumab疗效的影响：一项病例对照研究。

目的：评价既往特立帕肽（TPTD）治疗对罗莫索单抗（romosozumab）治疗绝经后骨质疏松症疗效的影响。方法：在这项回顾性、病例对照、多中心研究中，323例绝经后患者接受了ROMO治疗。其中275例为treatment-naïve， 48例从TPTD转为不间断ROMO治疗12 个月。采用倾向评分匹配确保临床可比性，每组44例。基线特征包括平均年龄78.0 岁，腰椎（LS） t评分为-3.6，全髋关节（TH） t评分为-2.8。在12个月期间评估骨密度（BMD）和血清骨转换指标。结果：在1-12 个月期间，treatment-naïve组骨形成标志物PINP的增加率明显高于tppd切换组。相反，骨吸收标志物TRACP-5b的减少在两组之间相似，表明tppd开关组的合成代谢窗口减少。12 个月后，tppd切换组在LS中显示出较低的骨密度增加(10.3 % vs. 17.3 %；P = 0.002)和TH(3.1 % vs. 7.8 %；P = 0.002)与treatment-naïve组比较。多元回归分析显示，12个月骨密度增加百分比(LS；β = 0.30;95 % CI = 0.85 - -11.61;P = 0.024 / th；β = 0.32;95 % CI = 0.51 - -8.56;P = 0.028)，与之前的TPTD治疗相比为treatment-naïve。结论：先前的TPTD治疗可能会减弱ROMO的有效性，可能是由于骨形成激活减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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