Journal of Bone and Mineral Research最新文献

{"title":"Investigating Factors Influencing the Long-Term Outcome of Teriparatide Treatment on the Risk of Hip Fracture. Is sequential treatment essential?","authors":"Szilvia Meszaros, Balazs Szili, Boglarka Szabo, Zsuzsanna Nemeth, Balint Mazzag, Robert Frigyesy, Eniko Jokai, Peter Lakatos, Istvan Takacs","doi":"10.1093/jbmr/zjag156","DOIUrl":"https://doi.org/10.1093/jbmr/zjag156","url":null,"abstract":"<p><strong>Introduction: </strong>Teriparatide (TPTD) is an anabolic therapy for severe osteoporosis. Clinical trials have shown its efficacy in reducing vertebral and non-vertebral fractures, data on hip fracture prevention in real-world settings and the impact of sequential antiresorptive (AR) therapy remain limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Hungarian National Health Insurance Database, which covers the entire population (~9.7 million). Patients with osteoporosis who received TPTD between 2010 and 2023, with treatment initiated by January 1, 2022. Hip fractures were tracked from day 180 after TPTD initiation for up to five years. Adherence was assessed via medication possession ratio. Post-TPTD AR therapy (bisphosphonate or denosumab) and the timing of its initiation were evaluated as factors influencing hip fracture risk. Poisson regression models were applied, adjusting for demographics, prior fractures, and healthcare utilization.</p><p><strong>Results: </strong>Among 8,893 eligible patients, 574 hip fractures occurred during follow-up. High adherence was associated with reduced hip fracture risk by 20% (p<0.05). The number of fractures prior to treatment was also associated with fracture risk, increasing it by 11% (p<0.05). Delayed AR initiation was closely related to a proportional increase in risk, which grew proportionally with the time elapsed between the two treatments. In a cohort of patients exhibiting high adherence, deferring AR treatment for over 90 days post-TPTD therapy was associated with an increase of 19% in hip fracture risk when subsequent treatment involved bisphosphonates, and a 31% increase when denosumab was utilized as the follow-up therapy.</p><p><strong>Conclusions: </strong>The efficacy of teriparatide treatment was associated with patient adherence and the number of prior fractures. Neglecting to initiate AR treatment following teriparatide therapy, or starting it late, was strongly linked to an increased risk of hip fractures. Our findings provide real-world data supporting timely initiation of AR therapy post-TPTD for sustained fracture prevention.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149369754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunistic Osteoporosis Screening Using CT-Derived Volumetric Bone Mineral Density Reference Curves.","authors":"Bryn E Matheson, Matthias Walle, Lauren A Burt, Carrie Ye, Steven K Boyd","doi":"10.1093/jbmr/zjag158","DOIUrl":"https://doi.org/10.1093/jbmr/zjag158","url":null,"abstract":"<p><p>Computed tomography (CT) scans are a widely available yet underused resource that can be leveraged for opportunistic osteoporosis screening. This study aimed to develop sex- and site-specific reference curves for volumetric bone mineral density (vBMD) to define dual X-ray absorptiometry (DXA)-anchored percentile thresholds for osteoporosis classification, and to evaluate whether these thresholds identified individuals who subsequently sustain a major osteoporotic fracture (MOF). A retrospective cohort of 4,418 clinical CT scans was analyzed, including a subset of 1,088 scans with corresponding DXA imaging within one year. MOF incidence and timing following CT were obtained from linked administrative health data. CT images were segmented with deep learning models to extract the first lumbar vertebra (L1) and femoral neck from which vBMDs were assessed using internal calibration. Sex-specific vBMD centile curves were generated for each region using Generalized Additive Models for Location, Scale and Shape. A receiver operating characteristic analysis with the Youden index defined percentile thresholds that aligned with DXA-defined osteoporosis. Clinical relevance was assessed by determining the proportion of participants classified as osteoporotic by the CT-derived percentile thresholds who subsequently sustained a MOF, and by evaluating the association between CT-defined osteoporosis and time to incident fracture using Cox proportional hazards models. The cohort included 2,368 males and 2,050 females. At the vertebral body, 66.3% (n=67) of female and 41.9% (n=26) of male fracture cases had vBMD values below the CT-defined osteoporosis threshold, consistent with osteoporosis. Among these, 44.8% (n=30) of females and 76.9% (n=20) of males had not undergone DXA screening. Individuals classified as osteoporotic based on CT-derived thresholds had up to 2.86 times higher risk of sustaining an MOF across all vertebral sites in both sexes. These findings indicate that CT-derived vBMD percentile thresholds offer clinically meaningful cut-points for opportunistic screening and support their use as a diagnostic flag for further evaluation.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149369755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Pathogenesis of Medication-Related Osteonecrosis of the Jaw.","authors":"Weidong Liu, Chenghao Jiang, Yili Liu, Fei Jiang, Junjun Jing, Jiahui Du, Xinquan Jiang","doi":"10.1093/jbmr/zjag153","DOIUrl":"https://doi.org/10.1093/jbmr/zjag153","url":null,"abstract":"<p><p>Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with bone-modifying and antiangiogenic therapies. As the use of these agents expands in osteoporosis management and cancer care, the population at risk of MRONJ is increasing. Despite its substantial clinical burden, effective prevention and treatment remain limited by an incomplete understanding of its pathogenesis and of the biological features that may confer susceptibility to the jaws. This review critically synthesizes current evidence across five potentially interacting pathogenic domains: impaired bone remodeling, compromised vascular and lymphatic support, impaired oral soft-tissue healing, microbial dysbiosis and biofilm formation, and immune dysregulation. Systemic comorbidities and concomitant therapies are also considered as potential modifiers of disease susceptibility and clinical course. In addition, we examine jaw-specific susceptibility by integrating evidence from developmental biology, comparative anatomy, cellular pharmacology, and local osteoimmune biology. Together, these observations support a multifactorial model of MRONJ in which drug-specific effects interact with local tissue characteristics and host factors, while the temporal sequence and relative contribution of individual mechanisms remain incompletely defined. A more precise understanding of these interactions may improve risk stratification and inform future preventive and therapeutic strategies.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of anti-RANKL, zoledronate or combination therapy in a mouse model of fibrous dysplasia: a preclinical study (Editorial).","authors":"Elena Tsourdi","doi":"10.1093/jbmr/zjag121","DOIUrl":"10.1093/jbmr/zjag121","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1155-1156"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: The impact of segmentation approach on HR-pQCT microarchitectural and biomechanical metrics depends on bone structure.","authors":"","doi":"10.1093/jbmr/zjag116","DOIUrl":"10.1093/jbmr/zjag116","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1279"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle function, linear growth, and bone health during 30 months of vamorolone, prednisone, and deflazacort treatment for Duchenne muscular dystrophy: a comparative study.","authors":"Leanne M Ward, Stefan Jackowski, Utkarsh J Dang, Maya Scharke B Comm, Jacob L Jaremko, Khaldoun Koujok, Mary-Ann Matzinger, Nazih Shenouda, Hugh J McMillan, Kerry Siminoski, Mika Leinonen, Raoul Rooman, Shabir Hasham, Paula R Clemens, Michela Guglieri, Eric P Hoffman","doi":"10.1093/jbmr/zjag154","DOIUrl":"https://doi.org/10.1093/jbmr/zjag154","url":null,"abstract":"<p><p>Corticosteroids are standard of care to slow disease progression in Duchenne muscular dystrophy (DMD) despite impaired growth and increased fracture risk. Vamorolone, a dissociative corticosteroid approved for DMD, showed stable growth and serum bone turnover markers in the 48-week VISION-DMD study. We compared muscle function and bone health from the non-randomized, open-label, 30-month Phase 2a VBP15-002/003/LTE trials (NCT02760264/NCT02760277/NCT03038399) in treatment-naive boys with DMD, aged 4 to <7 years at baseline, with data from matched corticosteroids-treated boys from FOR-DMD (NCT01603407). Motor function by slope-of-change analysis was evaluated for vamorolone 2-6 mg/kg/d through 30 months compared with propensity score-matched boys from FOR-DMD who received daily prednisone (starting dosage 0.75 mg/kg/d) or deflazacort (0.9 mg/kg/d) for 36 months. Anthropometric and bone assessments were performed in boys on vamorolone for 30 months, including those who received lower dosages during VBP15-002/003 (0.25/0.75 mg/kg/d for 6 months). Vertebral fracture (VF) prevalence was compared with baseline-matched FOR-DMD data. Thirty-month vamorolone VF results were adjusted to approximate expected fracture prevalence at 36 months. All slope-of-change motor function comparisons between vamorolone (N=22) and prednisone (N=32) or deflazacort (N=34) groups yielded no significant differences (p>0.05). Thirty-month height z-scores remained stable from baseline for vamorolone (N=36; +0.078 least-squares-mean change) and decreased from baseline for prednisone (N=27, -0.668; change versus vamorolone: p<0.0001 mixed models for repeat measures) and deflazacort (N=28, -0.928; change versus vamorolone: p<0.0001). VF prevalence on vamorolone (8 VF in 5/39 boys [12.8%]) was ~50% lower than prednisone (13 VF in 7/27 boys [25.9%]) and deflazacort (19 VF in 8/28 boys [28.6%]). Compared with prednisone and deflazacort, vamorolone demonstrated similar motor function efficacy with significantly fewer VF and preserved growth.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating fracture risk after stoke: a call to action to optimize skeletal health after stroke?","authors":"Robert A Wermers","doi":"10.1093/jbmr/zjag075","DOIUrl":"10.1093/jbmr/zjag075","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1151-1152"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of osteoporosis, sarcopenia, and osteosarcopenia with mortality: a comparative analysis for different sarcopenia definitions in the Manitoba and NHANES populations.","authors":"Xinwei Wang, William D Leslie, Lisa M Lix, Mackenzie Ryann Alexiuk, Navdeep Tangri, Xiaohua Zhang, Qi Meng, Chao Ma, Shuman Yang","doi":"10.1093/jbmr/zjag050","DOIUrl":"10.1093/jbmr/zjag050","url":null,"abstract":"<p><p>Osteosarcopenia (OSP) is a major public health concern, but its association with mortality, remains understudied. We aimed to examine the associations between osteoporosis, sarcopenia, and OSP with mortality. We used 2 populations: the Manitoba Bone Mineral Density Database (MBMDD) study (1999-2018) and the National Health and Nutrition Examination Survey (NHANES) study (2001-2019). Individuals aged 50 yr or above with complete data on BMD, appendicular lean body mass, demographic characteristics, and comorbidity measures. Five definitions for diagnosis of SP were considered: Foundation for the National Institutes of Health (FNIH1 and FNIH2), European Working Group on Sarcopenia in Older People (EWGSOP2), Asian Working Group for Sarcopenia (AWGS), and International Working Group on Sarcopenia (IWG). Disease was classified as follows: osteoporosis only (individuals with osteoporosis alone), sarcopenia only (individuals with sarcopenia alone), and OSP (individuals with both osteoporosis and sarcopenia). The main outcome was all-cause mortality. The MBMDD and NHANES included 69 497 (90.8% females) and 8134 (52.1% females), respectively. The average ages were 65.6 ± 9.5 yr in the MBMDD cohort and 59.1 ± 8.5 yr in the NHANES. Mortality was significantly higher in those with osteoporosis (MBMDD: hazard ratio [HR]: 1.26, 95% CI: 1.21-1.32; NHANES: HR: 1.31, 95% CI: 1.07-1.60), sarcopenia (EWGSOP2: MBMDD: HR: 1.64, 95% CI: 1.52-1.78; NHANES: HR: 1.45, 95% CI: 1.30-1.62), and OSP (EWGSOP2: MBMDD: HR: 2.05, 95% CI: 1.91-2.19; NHANES: HR: 1.91, 95% CI: 1.45-2.52). In summary, osteoporosis, sarcopenia, and OSP were all significantly associated with increased mortality risk. Osteosarcopenia exhibited a stronger association with mortality than either osteoporosis or sarcopenia alone.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1218-1231"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertebral fractures in a young woman: the impact of hypogonadism, glucocorticoids, and chronic disease.","authors":"Madhuni Herath, Hanh H Nguyen, Frances Milat, Peter R Ebeling","doi":"10.1093/jbmr/zjag088","DOIUrl":"10.1093/jbmr/zjag088","url":null,"abstract":"<p><p>A premenopausal woman was reviewed for painful vertebral fractures in the context of prednisolone exposure for her newly diagnosed systemic lupus erythematosus (SLE). Known clinical risk factors for bone loss included exposure to depot medroxyprogesterone acetate (MPA) for 12 yr, cigarette smoking, a family history of osteoporosis and ongoing inflammatory arthritis. Initial investigations also identified vitamin D deficiency and low bone mass for age and sex. She was treated with vitamin D, and her contraception was changed to a levonorgestrel intrauterine device. In the context of further vertebral fractures confirmed with both MRI and bone scan and having had additional secondary causes of low bone mass excluded, she commenced targeted osteoporosis treatment. We discuss the complexities of managing bone fragility in young adults and the impact of depot MPA, inflammatory disease (SLE), and glucocorticoid-induced osteoporosis (GIO) on younger adults. In this woman, antiresorptive therapy with zoledronic acid was recommended; we also explore the existing evidence-base for antiresorptive and anabolic therapies in younger adults, with a particular focus on GIO.</p>","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1180-1185"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Time-lapse HR-pQCT reliably assesses and monitors local bone turnover in patients with chronic kidney disease.","authors":"","doi":"10.1093/jbmr/zjag115","DOIUrl":"10.1093/jbmr/zjag115","url":null,"abstract":"","PeriodicalId":185,"journal":{"name":"Journal of Bone and Mineral Research","volume":" ","pages":"1278"},"PeriodicalIF":6.5,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13716907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}