Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA最新文献

{"title":"Response to letter to the editor: Clinical interpretation and screening thresholds for AI-derived bone mineral density.","authors":"Shau-Huai Fu, Chen-Yu Wang, Tzu-Hao Tseng","doi":"10.1007/s00198-026-08208-x","DOIUrl":"10.1007/s00198-026-08208-x","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"2159-2160"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Pre-teriparatide anti-osteoporosis medication therapy and fracture-related hospitalization in patients at very high fracture risk\".","authors":"Xiaotong Han, Maowei Yang","doi":"10.1007/s00198-026-08171-7","DOIUrl":"10.1007/s00198-026-08171-7","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"2153-2154"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148582129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Romosozumab in older adults: real-world patterns in fracture liaison service cohort.","authors":"Bernardo A Cedeno-Veloz, Alba M Rodríguez García, Ainhoa Casajús, Irene Guruceaga-Eguillor, Virginia Ruiz-Izquieta, Idoya Zazpe, Nicolás Martínez-Velilla","doi":"10.1007/s00198-026-08177-1","DOIUrl":"10.1007/s00198-026-08177-1","url":null,"abstract":"<p><p>Evidence on romosozumab use in very old adults managed in FLS remains limited. In this descriptive real-world cohort, patients receiving romosozumab had a higher baseline fracture risk phenotype than those receiving antiresorptive therapies, reflecting indication-based prescribing in routine care. Monthly romosozumab showed high 12-month scheduled-treatment completion, whereas completion was lower with daily administered teriparatide. These findings, although exploratory, support the use of romosozumab as a practical option for patients at very high risk.</p><p><strong>Purpose: </strong>To describe baseline treatment-allocation profiles and 12-month scheduled-treatment completion among older adults initiating romosozumab and other osteoporosis therapies in routine fracture liaison service (FLS) care and to explore clinical, functional, laboratory, and densitometric trajectories over follow-up.</p><p><strong>Methods: </strong>Retrospective, single-center observational cohort study (Hospital Universitario de Navarra FLS, 2022-2024). Patients at imminent fracture risk (≥ 1 fragility fracture within 24 months before baseline) initiating romosozumab were identified; for each, one patient initiating denosumab, zoledronic acid, and teriparatide was selected by calendar time (same month ± 3 months). Outcomes were assessed at 3 and 12 months. Between-group comparisons used Kruskal-Wallis tests (continuous variables) and Fisher-Freeman-Halton exact tests (categorical variables); when significant, Dwass-Steel-Critchlow-Fligner pairwise tests were performed with Holm-Bonferroni correction. Given the small sample size and non-random treatment allocation, analyses were considered descriptive and hypothesis-generating.</p><p><strong>Results: </strong>Sixty-eight patients were included (n = 17/group). Baseline profiles differed across treatments, consistent with indication-based prescribing; estimated fracture risk (FRAX/QFracture) was higher in anabolic-treated groups. At 12 months, scheduled-treatment completion was 100% among evaluable patients receiving denosumab, romosozumab, and zoledronic acid versus 52.9% with teriparatide; romosozumab versus teriparatide remained significant after Holm adjustment (p = 0.016). Incident fractures and adverse drug reactions were infrequent, and no significant between-group differences were observed in mortality, emergency visits, admissions, falls, fractures, or adverse drug reactions over follow-up. Treatment sequencing at 12 months differed significantly, with heterogeneous post-index regimens after romosozumab and after teriparatide.</p><p><strong>Conclusion: </strong>In this descriptive older adults FLS cohort, romosozumab recipients represented a higher-risk phenotype but showed broadly similar 12-month clinical trajectories compared with other therapies; monthly romosozumab showed high 12-month treatment completion and broadly similar short-term clinical trajectories to other treatment pathways, supporting its ","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"2133-2139"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis in rheumatoid arthritis: a new perspective on risk factors and clinical prediction models.","authors":"Yubo Shao, XiaoYu Yang, Qi Shi, Zihang Xu, Qianqian Liang","doi":"10.1007/s00198-026-08059-6","DOIUrl":"10.1007/s00198-026-08059-6","url":null,"abstract":"<p><p>Osteoporosis (OP) is a prevalent and serious comorbidity in rheumatoid arthritis (RA), significantly increasing the fracture burden. Although early detection is crucial, OP screening in RA is often delayed, representing an unmet clinical need. Clinical prediction models (CPMs) offer a solution for early risk stratification, yet a synthesis that integrates RA-OP risk factors and evaluates existing CPMs is lacking. This review addresses this gap by delineating the multidimensional risk network for RA-OP and evaluating the development, performance, and applicability of current CPMs. We find that despite evolution from basic to sophisticated biomarker-integrated algorithms, most CPMs are constrained by modest sample sizes, insufficient external validation, and suboptimal clinical translatability. The current paradigm focuses predominantly on diagnosis rather than prognosis. To address these limitations, future research should aim to enhance the methodological rigor and generalizability of models, expand their predictive scope to encompass future risk of OP and fractures, and develop RA-specific fracture prediction tools that incorporate disease-specific pathophysiology, with performance rigorously benchmarked against established tools such as the fracture risk assessment tool (FRAX). Progress along these lines may help shift the management paradigm toward more proactive and personalized prevention, with the potential to improve long-term skeletal health outcomes in RA.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"1915-1927"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of physical exercise and health education for the management of osteoporotic vertebral fractures: a systematic review and meta-analysis.","authors":"M Fernández-González, M Mora-Traverso, P Molina-Garcia, R Prieto-Moreno, M Ortiz-Piña, J Contreras-Gutiérrez, P Ariza-Vega","doi":"10.1007/s00198-026-07994-8","DOIUrl":"10.1007/s00198-026-07994-8","url":null,"abstract":"<p><p>Osteoporotic vertebral fractures (OVFs) are the second most common fractures in osteoporosis, often leading to reduced functional capacity, chronic pain, and lower quality of life. Physical exercise and health education are considered promising options for managing these symptoms. To determine the effectiveness and safety of exercise and health education compared to usual care in patients with OVFs. A literature search up to April 2024 was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library. Clinical trials involving adults with OVFs were included, focusing on physical capacity (primary outcome) and other health outcomes. Study selection, bias assessment, and data extraction were independently conducted by two authors, with a third author resolving conflicts. Nineteen studies were included in the meta-analysis of exercise interventions. Exercise interventions were analyzed using a standardized mean difference (SMD) meta-analysis, with additional sensitivity analyses. Physical exercise significantly improves functional capacity (SMD -0.41; 95% CI -0.69 to -0.14; p 0.003), aerobic capacity, balance, trunk muscle strength, pain, and quality of life in patients with OVF. No significant effects were observed on thoracic posture or fear of falling. Adverse event risk was low (6%), comparable to usual care or daily activities. Health education interventions (two studies) were synthetized narratively, both showing improvements in pain, mobility, and patient knowledge. Physical exercise is effective and safe in the recovery of OVFs; thus, its prescription is recommended. Most interventions focus first on core strength and motor control and then on aerobic and resistance training. Further evidence is needed to demonstrate the effectiveness of health education.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"1929-1944"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Don't tell me I'm going to feel joy\": The emotional burden of informal caregivers of patients with a fragility fracture discharged from a rehabilitation hospital.","authors":"Kathryn Hodwitz, Mohamed El-Hussein, Jill I Cameron, Lynn M Meadows, Jennifer Watt, Maureen Ashe, Jenna Phan, Fariba Aghajafari, Larry Funnell, Ashley Verduyn, Joanna E M Sale","doi":"10.1007/s00198-026-08027-0","DOIUrl":"10.1007/s00198-026-08027-0","url":null,"abstract":"<p><p>The emotional experience of informal caregiving is considerable and complex, consisting of tensions internally and with the care recipient, and exacerbated by pressures to adopt the caregiver role without complaint or assistance. Our findings demonstrate the need to develop policies to relieve distress for caregivers of fragility fracture patients.</p><p><strong>Purpose: </strong>Informal caregiving can have considerable physical and psychosocial consequences, with the emotional strain of caregiving considered most distressing. Few studies have examined the emotional experience of caregiving for individuals with a fragility fracture or the contextual factors that may influence this experience. We aimed to explore the experience of caring for someone after a fragility fracture to understand the nuances of the emotional experience and identify ways to better support informal caregivers in the future.</p><p><strong>Methods: </strong>We used a phenomenological approach to examine caregivers' experiences. We recruited primary caregivers of patients discharged from a rehabilitation hospital following a fragility fracture. We conducted individual interviews with caregivers and analyzed the data phenomenologically to describe the structure of caregivers' emotional experiences and illuminate potential influencing factors.</p><p><strong>Results: </strong>We interviewed 32 caregivers (19 females, 13 males; 37-95 years old). We found that the emotional experience of caregiving was complex, consisting of tensions internally and with care recipients, and exacerbated by multiple pressures to adopt the caregiver role. As a result of these pressures, caregivers often felt reluctant to voice displeasure or ask for help, exacerbating their burden and reinforcing a sense that they must suffer in silence.</p><p><strong>Conclusion: </strong>Our study demonstrates the multifaceted nature of caregivers' emotional burden and highlights the pressures felt by caregivers of fragility fracture patients to take on caregiving roles without complaint or assistance. Our findings highlight the need to acknowledge the emotional complexity of caregiving, empower caregivers to ask for help, and develop meaningful supports and policies to alleviate caregiver burden.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"2121-2131"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: high prevalence of sarcopenia, osteoporosis and osteosarcopenia in patients with chronic kidney disease compared with healthy controls.","authors":"Anahita Rashid, Sabina Chaudhary Hauge, Barbara Rubek Nielsen, Bo Zerahn, Anne Sofie Fredberg Jørgensen, Subagini Nagarajah, Morten Frost Nielsen, Maria Lerche Mace, Anders Nordholm, Charlotte Suetta, Ditte Hansen","doi":"10.1007/s00198-026-08131-1","DOIUrl":"10.1007/s00198-026-08131-1","url":null,"abstract":"","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"2147-2148"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parathyroid hormone and alkaline phosphatase are associated with fracture risk in non-dialysis-dependent chronic kidney disease.","authors":"C S H Pichat, E L F Ballegaard, I O Bressendorff, H S Jørgensen, N Carlson, D Hansen","doi":"10.1007/s00198-026-08035-0","DOIUrl":"10.1007/s00198-026-08035-0","url":null,"abstract":"<p><p>We studied over 45,000 Danish adults with non-dialysis-dependent chronic kidney disease to assess whether parathyroid hormone (PTH) and alkaline phosphatase (ALP) were associated with fracture risk. Elevated PTH (over twice normal) and ALP (above 70 U/L) were linked to higher fracture rates, suggesting these markers may help identify high-risk patients.</p><p><strong>Purpose: </strong>Patients with chronic kidney disease (CKD) have an increased risk of bone fracture. We aimed to examine the association between parathyroid hormone (PTH), alkaline phosphatase (ALP), and fracture risk in non-dialysis-dependent CKDG3-5.</p><p><strong>Methods: </strong>Danish adults with eGFR < 60 ml/min/1.73 m² and measured PTH were identified from nationwide healthcare registers between 2010 and 2022. PTH was standardized to the assay-specified upper normal limit (UNL) and stratified as normal, slightly elevated (1.1-2.0 × UNL), high (2.1-4.0 × UNL), and very high (≥ 4.0 × UNL). ALP was stratified as low to low-normal (< 70 U/L), upper-normal (70-105 U/L), slightly elevated (106-125 U/L), and high (> 125 U/L). Rates of major osteoporotic fracture (MOF; hip, vertebra, wrist, and humerus fracture) and any fracture were estimated in multiple Cox regression models adjusted for relevant confounders.</p><p><strong>Results: </strong>Among 45,611 included individuals adjusted rates of MOF were increased in patients with high PTH (hazard ratio (HR) 1.15, 95% confidence interval (CI) 1.04-1.26, p = 0.005) and very high PTH (HR 1.23, 95% CI 1.04-1.46, p = 0.012), compared to patients with normal PTH. Patients with ALP levels in the upper-normal (HR 1.11, CI 1.02-1.20, p = 0.01), slightly elevated (HR 1.29 CI 1.13-1.47, p < 0.001), and high (HR 1.59, CI 1.39-1.75, p < 0.001) categories showed significantly higher rates of MOF compared to low to low-normal ALP. We found similar HRs of any fracture event stratified by ALP- and PTH levels.</p><p><strong>Conclusion: </strong>Our nationwide observational cohort study demonstrates that PTH and ALP were positively associated with fracture risk in non-dialysis-dependent CKDG3-5.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"1991-2003"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity resistance and impact exercise in menopausal women: a systematic review of intervention reporting quality and training content.","authors":"Emanuele Tortoli, Gennaro Riccio, Elisa Mattii, Simone Ghezzi, Giuseppe Giovannico, Matteo Cioeta","doi":"10.1007/s00198-026-08078-3","DOIUrl":"10.1007/s00198-026-08078-3","url":null,"abstract":"<p><strong>Background: </strong>High-intensity resistance and impact training (HiRIT) has emerged as a promising strategy to counteract bone loss and functional decline in peri- and postmenopausal women. However, heterogeneity in intervention design and inadequate reporting limit reproducibility and clinical applicability. The Consensus on Exercise Reporting Template (CERT) provides a standardized framework for evaluating the completeness of exercise intervention reporting. Therefore, this review aimed to assess the reporting quality of HiRIT interventions using the CERT and to describe the key characteristics and training content of the implemented protocols.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. Six electronic databases were searched up to June 2025. Original studies investigating HiRIT interventions in peri- or postmenopausal women were included. Reporting quality was assessed using the 19-item CERT checklist by two independent reviewers.</p><p><strong>Results: </strong>Thirty-nine studies involving 3349 women (mean age 57.6 years) met the inclusion criteria. The mean CERT score was 14.3 out of 19, indicating moderate to good reporting quality. Exercise description, supervision, intervention structure, and equipment were consistently reported, whereas motivation strategies, home-based components, and detailed individualization were frequently omitted. Four progression-related CERT items were adequately reported in approximately two-thirds of the studies. Commonly prescribed exercises included the overhead press, squat, leg press, deadlift, and high-impact jumping tasks.</p><p><strong>Conclusions: </strong>HiRIT trials in peri- and postmenopausal women generally report core exercise components adequately, but important gaps remain in the reporting of progression, individualization, and behavioral support strategies. Improving the completeness and transparency of exercise reporting through consistent use of frameworks such as the CERT is essential to enhance reproducibility, facilitate clinical implementation, and optimize exercise prescription for bone health in this population.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"1945-1978"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased osteoporosis burden and comparative antiresorptive effectiveness in inflammatory bowel disease: a real-world cohort study.","authors":"Aakash Desai, Himsikhar Khataniar, Hany Habib, Jana G Hashash, Francis A Farraye, Miguel Regueiro, Millie Long, Gursimran S Kochhar","doi":"10.1007/s00198-026-08020-7","DOIUrl":"10.1007/s00198-026-08020-7","url":null,"abstract":"<p><p>Contemporary IBD care lacks precise osteoporosis risk estimates and data on comparative therapy. In U.S., IBD patients had a 56% higher 5-year risk of a new osteoporosis diagnosis (highest in Crohn's disease); denosumab matched bisphosphonates for 1-2-year fracture prevention in this population. Our study prioritizes early screening, steroid-sparing strategies, and individualized antiresorptive therapy.</p><p><strong>Background: </strong>Osteoporosis is a frequent extra-intestinal complication of inflammatory bowel disease (IBD), yet its current burden and the comparative efficacy of available anti-resorptive therapies remain uncertain.</p><p><strong>Methods: </strong>Using the US TriNetX network we formed two retrospective cohorts. (1) Adults with IBD (2013-2023) were 1:1 propensity-matched to non-IBD controls to estimate 5-year risk of new osteoporosis diagnosis and identify determinants. (2) IBD patients with osteoporosis initiating denosumab or bisphosphonates (2013-2022) were matched for demographics, comorbidities, and IBD phenotype; spine/hip fractures and risk for incident onset fractures were calculated for both the cohorts.</p><p><strong>Results: </strong>Among 143,248 patients with IBD (mean age 44.2 y; 51.8% female), risk of new osteoporosis diagnosis exceeded controls by 58% at 1 year (adjusted odds ratio [aOR] 1.58, 95% CI 1.51-1.65) and was highest in Crohn's disease (CD) (aOR 1.79, 95% CI 1.68-1.90); ulcerative colitis (UC) also demonstrated increased 1-year risk (aOR 1.47, 95% CI 1.39-1.56). Subgroup analysis showed increased risk in patients age > 65, female sex and Asian race for UC. For CD, age > 65, female sex, nicotine dependence and alcohol use were associated with increased risk. The osteoporosis treatment cohort included 2,423 patients (520 denosumab and 1,903 bisphosphonates). After matching, denosumab produced similar 1-year (2.33% vs 3.49%, aOR 0.65 CI 0.31-1.38) and 2-year (4.65% vs 6.78%; aOR 0.67, CI: 0.39-1.14) fracture rates compared to bisphosphonates.</p><p><strong>Conclusion: </strong>IBD confers a substantially higher and multifactorial osteoporosis risk. Denosumab showed similar observed short-term fracture rates to bisphosphonates, although clinically meaningful differences could not be excluded. Early bone-health screening, steroid-sparing therapy, and individualized antiresorptive treatment remain essential.</p>","PeriodicalId":520737,"journal":{"name":"Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA","volume":" ","pages":"1979-1990"},"PeriodicalIF":5.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}