Archives of Osteoporosis最新文献

{"title":"Rising burden of fall-related vertebral fractures in Ecuador, 1990–2021: an analysis of the global burden of disease","authors":"Enrique Lopez Gavilanez,&nbsp;Luis Imaicela Naula,&nbsp;Manuel Navarro Chávez,&nbsp;Noemi Bautista Litardo,&nbsp;Mario Hernández Bonilla,&nbsp;Roberto Cedeño German,&nbsp;Abigail Segura Mestanza,&nbsp;Mario Navarro Grijalva,&nbsp;Kempis Guerrero Franco","doi":"10.1007/s11657-026-01761-2","DOIUrl":"10.1007/s11657-026-01761-2","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Fall-related vertebral fractures increased substantially in Ecuador from 1990–2021, with rising incidence and disability beyond population aging. Improved detection and secondary prevention are essential.</p><h3>Background</h3><p>Vertebral fractures are a major complication of bone fragility and a leading cause of chronic pain and disability in aging populations. Long-term national data are essential for guiding prevention efforts and healthcare system planning.</p><h3>Objectives</h3><p>To describe trends in the incidence and prevalence of fall-related vertebral fractures, as well as years lived with disability (YLDs), of fall-related vertebral fractures among adults aged ≥ 50 years in Ecuador between 1990 and 2021 by using estimates from the Global Burden of Disease 2021 study.</p><h3>Methods</h3><p>An ecological time-series analysis was conducted using modeled epidemiological estimates from the Global Burden of Disease (GBD) 2021 study. The incidence, prevalence, and YLDs were evaluated as absolute numbers and age-standardized rates (ASRs) per 100,000 population, stratified by sex and age. Temporal trends were assessed using Joinpoint regression to estimate annual percentage change (APC) and average annual percentage change (AAPC).</p><h3>Results</h3><p>Between 1990 and 2021, the age-standardized incidence, prevalence, and YLD rates of fall-related vertebral fractures among adults aged ≥ 50 years increased from 65.8 to 97.4, 28.9 to 43.9, and 3.03 to 4.59 per 100,000, respectively. The absolute number of cases more than quadrupled. Men consistently showed higher ASRs, whereas women demonstrated sustained growth across all indicators. Disability was unevenly distributed among adults aged ≥ 70 years, especially those aged ≥ 80 years. Joinpoint analyses revealed early increases followed by stabilization in men and continuous upward trends in women.</p><h3>Conclusions</h3><p>The incidence and disability rates of fall-related vertebral fractures in Ecuador have increased substantially over the past three decades, beyond demographic aging alone. Given the growing burden on older adults, fracture detection, secondary prevention, and integrated strategies for osteoporosis management need to be improved.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148782565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of denosumab: a 10-year single-center retrospective study","authors":"Federico Aldegheri,&nbsp;Matteo Appoloni,&nbsp;Nicolò Passoni,&nbsp;Vittorio Zibordi,&nbsp;Maurizio Rossini,&nbsp;Davide Gatti,&nbsp;Giovanni Adami,&nbsp;Francesco Pollastri,&nbsp;Angelo Fassio,&nbsp;Ombretta Viapiana","doi":"10.1007/s11657-026-01757-y","DOIUrl":"10.1007/s11657-026-01757-y","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Osteoporosis weakens bones and increases the risk of fractures. Denosumab is a medication that reduces bone loss and increases bone mineral density (BMD). In this real-world study, we followed patients who received denosumab every 6 months for 10 years. We found that bone density continued to improve throughout treatment. People who had taken bisphosphonates before starting denosumab responded just as well in the long term. Blood tests showed stable reduction of bone turnover markers.</p><h3>Background</h3><p>Denosumab produces durable BMD gains and low fracture rates in clinical trials, but long-term real-world evidence is limited, especially on the effect of prior bisphosphonate exposure and characteristics of patients who fracture during therapy.</p><h3>Methods</h3><p>We conducted a 10-year single-center real-world retrospective study including patients receiving continuous denosumab 60 mg every 6 months. Clinical, biochemical, and densitometric data were extracted from an institutional electronic database. Longitudinal changes in BMD at total hip, lumbar spine, and femoral neck were analyzed using linear mixed-effects models adjusted for baseline BMD, age, baseline severe vertebral fractures, and glucocorticoid exposure. Bone turnover markers (CTX, ALP, PTH) were analyzed with mixed-effects models adjusted for renal function.</p><h3>Results</h3><p>A total of 145 patients were included (mean age 70.9 years; 95.9% women). Over 10 years, BMD increased significantly at all skeletal sites: +12.9% at the total hip, + 16.3% at the lumbar spine, and +6.0% at the femoral neck. CTX and ALP showed marked and sustained reduction, whereas PTH remained stable over time. Prior bisphosphonate exposure did not modify long-term BMD trajectories at any site, and group differences in CTX converged after treatment initiation. Patients who sustained fractures showed significantly attenuated lumbar spine BMD gains, while hip sites displayed similar trajectories to non-fractured patients.</p><h3>Conclusions</h3><p>In a real-world setting, continuous denosumab therapy for 10 years produced robust and sustained BMD gains, accompanied by a durable and stable reduction in bone turnover. Prior bisphosphonate exposure influenced only early biochemical differences and did not affect decade-long BMD responses.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01757-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148782434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secular trends in osteoporosis prevalence at first presentation over 26 years in a regional Irish DEXA registry: a retrospective repeated cross-sectional analysis","authors":"Azrin Muslim,&nbsp;Eleanor Fallon,&nbsp;Nur Atikah Mohd Asri,&nbsp;Aine Costelloe,&nbsp;Tina Sheehy,&nbsp;Mary Griffin,&nbsp;Declan Lyons","doi":"10.1007/s11657-026-01764-z","DOIUrl":"10.1007/s11657-026-01764-z","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Declining osteoporosis prevalence at first DEXA presentation over 26 years in a regional Irish registry suggests improving baseline skeletal health independent of demographic shifts. If sustained, these trends may temper projected fracture burden, with implications for prevention strategies and health-system planning.</p><h3>Purpose</h3><p>Despite decades of investment in fracture prevention and growing clinical awareness of osteoporosis, whether the skeletal health of individuals presenting for assessment has actually improved remains unknown. We investigated secular trends in osteoporosis prevalence at first presentation using a regional Irish DEXA registry spanning 26 years.</p><h3>Methods</h3><p>In a retrospective repeated cross-sectional analysis, we examined all DEXA scans performed between January 1998 and December 2024 at two hospitals serving the Midwest region of Ireland, restricting analyses to each individual’s first scan to minimise treatment and surveillance bias. Osteoporosis was defined as a T-score of − 2.5 or lower at the total hip or lumbar spine. Logistic regression assessed calendar year as the exposure and osteoporosis as the outcome, adjusted for age and sex. Direct age standardisation and 3-year moving averages were used to stabilise annual estimates.</p><h3>Results</h3><p>Among 66,681 individuals undergoing a first DEXA scan (80.7% female), osteoporosis prevalence declined substantially. Hip osteoporosis fell from 19 to 7% and lumbar spine osteoporosis from 30 to 8% between 1998 and 2024. Each calendar year was associated with a 4.0% reduction in odds of hip osteoporosis (OR 0.960, 95% CI 0.957–0.964) and a 4.8% reduction in lumbar spine osteoporosis (OR 0.952, 0.949–0.955). These findings persisted after age standardisation and adjustment for scan volume.</p><h3>Conclusion</h3><p>Osteoporosis prevalence at first presentation declined by approximately two-thirds over nearly three decades, pointing to a meaningful improvement in skeletal health at the point of clinical assessment, with potential implications for future fracture burden projections.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01764-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148782435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal bone loss in patients with stage 3 CKD: a study based on densitometry and HR-pQCT","authors":"Kalyanna S. Bezerra de Carvalho,&nbsp;Ana Teresa P. Vieira,&nbsp;Luciene M. dos Reis,&nbsp;Rosa M. R. Pereira,&nbsp;Rosa M. A. Moyses,&nbsp;Rosilene M. Elias","doi":"10.1007/s11657-026-01728-3","DOIUrl":"10.1007/s11657-026-01728-3","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>In a 1-year longitudinal study of 34 patients with stage 3 CKD and stable bone turnover markers there was no deterioration of bony quality. However, HR-pQCT identified impaired bone density in 73.5% of cases at baseline, which was undetected by DXA. Findings suggest early skeletal involvement despite stable renal function.</p><h3>Purpose</h3><p>It has been postulated that chronic kidney disease (CKD) is associated with bone loss. However, prospective data are limited, and it remains unclear whether bone loss or microarchitecture chances occurs in the early stages of CKD with stable renal function.</p><h3>Methods</h3><p>In this longitudinal cohort study, patients with stage 3 CKD underwent dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT), with reassessment after 1 year. Bone biomarkers, including alkaline phosphatase, intact parathyroid hormone (iPTH), intact fibroblast growth factor-23 (iFGF-23), total procollagen type 1 N-terminal propeptide (tP1NP), and β-isomerized C-terminal telopeptide of type I collagen -I (β-CTX-I) were also measured.</p><h3>Results</h3><p>Thirty-four patients were included (51 ± 3 years, 44% men). Bone turnover markers remained stable during follow-up. Osteopenia and/or osteoporosis at one or more sites was found in 45.5% of participants. Low bone mineral density (BMD), T-score &lt; -1, was observed in 32.3% (lumbar spine), 29.4% (total hip), 14.7% (1/3 distal radius), and 26.5% (ultradistal radius). HR-pQCT revealed impaired BMD in at least one site (tibia or radius) in 73.5% of cases. Renal function remained stable during follow-up, with no significant changes in bone biomarkers. DXA showed a slight but significant decline in T-scores at the total hip and 1/3 distal radius, whereas HR-pQCT parameters remained unchanged.</p><h3>Conclusion</h3><p>In patients with stage 3 CKD and stable renal function, bone microarchitecture identified impaired BMD not fully detected by DXA. Over 1 year, however, only minimal changes in bone parameters were observed.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01728-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148782566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the activate depress free and repeat (ADFR) paradigm: Clinical use of cyclic romosozumab","authors":"Kristyn Hare,&nbsp;Shawna Wheeler,&nbsp;Christina Morganti,&nbsp;Diane Krueger,&nbsp;Donald Kimmel,&nbsp;Neil Binkley","doi":"10.1007/s11657-026-01750-5","DOIUrl":"10.1007/s11657-026-01750-5","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Osteoporosis treatment does not normalize BMD. We hypothesized cyclic romosozumab dosing might provide greater BMD increases. Cyclic therapy (six romosozumab monthly doses then one denosumab dose) produced broadly similar BMD increases as previously reported for 12 romosozumab doses. A second cycle further increased spine and hip BMD but with a blunted response.</p><h3>Purpose</h3><p>Evaluating novel osteoporosis medication approaches to maximize BMD is reasonable. A bone remodeling-based cyclic approach, i.e., activate, depress, free and repeat (ADFR), has been proposed. We hypothesized that short course romosozumab followed by denosumab represents an appropriate cycle. This exploratory retrospective case series reports six months of romosozumab treatment then one denosumab dose, followed by a second identical cycle.</p><h3>Methods</h3><p>Women at very high fracture risk were offered cyclic therapy. DXA was obtained at baseline, 1 and 2 years. Data from 41 women treated for 1, and 18 for 2 years are reported. Percent BMD change from baseline was evaluated by ANOVA.</p><h3>Results</h3><p>Patient mean (SD) age and BMI were 68.8 (6.6) years and 25.6 (5.0) kg/m² respectively. Mean total hip T-score was -2.5, FRAX estimated hip fracture risk was 6.9%. After one cycle, mean ± SEM% BMD increase (all p &lt; 0.001) from baseline at the lumbar spine (LS), total hip (TH) and femur neck (FN) was 12.6 ± 1.1%, 5.9 ± 0.8% and 4.4 ± 0.9% respectively. In 18 women completing a second cycle, BMD further increased to + 17.5% and + 8.7% at LS and TH, respectively. In a subset (<i>n</i> = 14) CTX was reduced from baseline (mean -78%) before cycle two with 11 below the lower limit of normal.</p><h3>Conclusion</h3><p>At one year, six monthly romosozumab doses then one denosumab dose substantially increased BMD. A second cycle further increased LS and TH BMD, but the response was blunted perhaps reflecting persistent turnover suppression by denosumab. Evaluation of novel romosozumab dosing approaches is indicated.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01750-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148752036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical risk factors associated with bone biopsy findings in CKD-associated osteoporosis: insights from the Brazilian Registry of Bone Biopsy (REBRABO)","authors":"Eduardo J. Duque,&nbsp;Lauren S. Lowe,&nbsp;Cinthia E. M. Carbonara,&nbsp;Rodrigo B. Oliveira,&nbsp;Thomas L. Nickolas,&nbsp;Rosilene M. Elias,&nbsp;Vanda Jorgetti,&nbsp;Luciene dos Reis,&nbsp;Aluizio B. Carvalho,&nbsp;Michael T. Yin,&nbsp;Rosa M. Moyses","doi":"10.1007/s11657-026-01756-z","DOIUrl":"10.1007/s11657-026-01756-z","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Chronic kidney disease–associated osteoporosis (CKD-OP) is a highly prevalent—yet frequently underrecognized—condition in patients with advanced CKD. The assessment of bone turnover, mineralization, and volume remains challenging in clinical practice, often requiring bone histomorphometric analysis. Using data from the Brazilian Registry of Bone Biopsies (REBRABO), we identified clinical characteristics associated with these histomorphometric parameters. These findings may help clinicians better characterize the underlying bone phenotype and support a more individualized approach to the diagnosis and management of CKD-associated osteoporosis.</p><h3>Purpose</h3><p>Chronic kidney disease–associated osteoporosis (CKD-OP) is characterized by impaired bone quality, and management of bone fragility in CKD partially relies on evaluating bone turnover (T), mineralization (M), and volume (V), through bone biopsy. However, bone biopsy data from large population-based cohorts are limited, making it challenging to identify clinical parameters that are associated with TMV patterns.</p><h3>Methods</h3><p>This cross-sectional study is based on data from the Brazilian Registry of Bone Biopsy (REBRABO) and includes 374 iliac crest bone biopsies from adult patients with CKD5D (median age 51 y), collected between August/15 and December/21. Each biopsy was classified according to bone turnover (low/normal vs. high), mineralization (normal vs. abnormal), and trabecular volume (normal vs. low). Demographic and laboratory parameters were also analyzed.</p><h3>Results</h3><p>No significant differences in TMV classification were observed based on ethnicity, sex, or diabetes status. Higher turnover was independently associated with younger age, hemodialysis modality, elevated parathyroid hormone (PTH), and alkaline phosphatase (ALP) levels, in a model adjusted for dialysis vintage, prior parathyroidectomy (PTX), and phosphate. Abnormal mineralization was independently associated with age, prior PTX, and lower serum calcium and phosphate, after adjustment for body mass index (BMI), PTH, and ALP. Low trabecular volume was independently associated with older age and lower BMI, in a model adjusted for PTH and history of fractures, and cannot be reliably inferred from biochemical markers. Notably, most patients with adynamic bone also presented with low trabecular volume.</p><h3>Conclusion</h3><p>Our findings suggest that younger patients undergoing hemodialysis with elevated PTH and ALP levels may benefit from a more intensive approach to the management of hyperparathyroidism. In contrast, older and more frail patients with relatively low PTH levels may be more likely to exhibit low bone volume and turnover and could potentially benefit from therapies aimed at stimulating bone formation, such as anabolic agents.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01756-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148752039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden and temporal trends attributable to low bone mineral density in Mexico, 1990–2023: a global burden of disease analysis","authors":"Pamela Munguía-Realpozo,&nbsp;Claudia Mendoza-Pinto,&nbsp;Ivet Etchegaray-Morales,&nbsp;Edith Ramírez-Lara,&nbsp;Miguel Ángel Saavedra-Salinas,&nbsp;Elizabeth Suárez-Belmont,&nbsp;Gustavo López-Gasca,&nbsp;Jorge Ayón-Aguilar,&nbsp;Máximo Alejandro García-Flores","doi":"10.1007/s11657-026-01758-x","DOIUrl":"10.1007/s11657-026-01758-x","url":null,"abstract":"<div><h3>Summary</h3><p>Low bone mineral density contributes to fractures and injury-related disability. Using Global Burden of Disease 2023 estimates for Mexico (1990–2023), we found rising total burden but declining age-standardised rates, with disability becoming increasingly important and a recent uptick in non-fatal outcomes. Strengthening fracture prevention is needed in ageing populations.</p><h3>Background</h3><p>Low bone mineral density (LBMD) is a modifiable risk factor for fractures and other injury-related outcomes; however, contemporary national estimates for Mexico remain limited, constraining policy planning and prevention priorities.</p><h3>Methods</h3><p>We conducted a secondary analysis of Mexico-specific Global Burden of Disease (GBD) 2023 estimates obtained from the IHME GBD Results Platform for adults aged ≥ 40 years from 1990 to 2023. We summarised all-age counts and age-standardised rates (ASRs) per 100,000 for deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs). Population exposure to LBMD was assessed using the summary exposure value (SEV). Temporal trends were evaluated using joinpoint regression, reporting annual percentage change (APC) and average APC (AAPC) with 95% CIs.</p><h3>Results</h3><p>From 1990 to 2023, all-age deaths increased from 2,962.99 to 4,042.72 and DALYs from 183,439.82 to 344,078.31, driven mainly by rising YLDs (116,520.80 to 255,652.37). Despite rising counts, ASRs declined: the age-standardised death rate decreased from 7.41 to 3.06 per 100,000, and the age-standardised DALY rate decreased from 422.13 to 247.52. Overall, AAPCs indicated sustained declines for mortality (− 2.7%) and YLLs (− 2.5%), while DALYs decreased more modestly (AAPC − 1.6%), with a recent post-2020 increase in DALYs (APC 3.7%/year) and YLDs (APC 5.2%/year). SEV decreased modestly from 20.80 in 1990 to 18.78 in 2023 and remained consistently higher in females than males. In descriptive time-series analyses, the Sociodemographic Index showed inverse co-movement with LBMD-attributable ASRs (mortality <i>rₛ</i> =  − 0.998; DALYs <i>rₛ</i> =  − 0.994; YLLs <i>rₛ</i> =  − 0.999; YLDs <i>rₛ</i> =  − 0.950; all <i>p</i> &lt; 0.001).</p><h3>Conclusions</h3><p>Mexico experienced rising absolute LBMD-attributable burden alongside declining age-standardised rates, with disability becoming increasingly prominent. These findings support strengthening fracture risk assessment, fall-prevention strategies, and post-fracture secondary prevention among Mexico’s ageing population.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148752040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis treatment with biosimilars in Malaysia and Thailand: a budget impact analysis","authors":"Linda Siachalinga,&nbsp;Arun Jones,&nbsp;Kyoo Kim,&nbsp;Martin Downes,&nbsp;Igor Solev,&nbsp;Kenneth Lee,&nbsp;Thanut Valleenukul,&nbsp;Hansoo Kim","doi":"10.1007/s11657-026-01752-3","DOIUrl":"10.1007/s11657-026-01752-3","url":null,"abstract":"<div><h3>Introduction</h3><p>Biologic treatments demonstrate long-term clinical benefits for patients with osteoporosis, but their cost is prohibitive, and access can be limited, particularly in low-income countries. This analysis determined the cost impact of introducing biosimilar denosumab for the treatment of osteoporosis in Malaysia and Thailand.</p><h3>Methods</h3><p>A budget impact model was developed to compare the cost of treating female patients aged ≥ 50 years with osteoporosis with biosimilar versus reference denosumab (60 mg/mL every 6 months) from a healthcare payer perspective in Malaysia and Thailand over 5-years. Model inputs included previously published, country-specific prevalence, incidence, mortality, and treatment data, supplemented by expert clinical advice where evidence was limited. Drug acquisition cost was assumed to cost 25% less than the reference product. Further assumptions included no change in osteoporosis incidence and mortality over the time horizon and consistent condition-related costs across both scenarios.</p><h3>Results</h3><p>Over 5 years, treatment with the reference denosumab was estimated to cost MYR ~ 864 million (USD ~ 217 million) in Malaysia and THB ~ 179.5 billion (USD ~ 5.2 billion) in Thailand. Biosimilar denosumab was estimated to cost MYR ~ 648 million (USD ~ 162 million) and THB ~ 134.6 billion (USD ~ 3.9 billion), resulting in potential savings of MYR ~ 216 million (USD ~ 54 million) and THB 44.8 billion (USD ~ 1.3 billion), respectively.</p><h3>Conclusion</h3><p>The introduction of biosimilar denosumab in Malaysia and Thailand could yield significant cost savings and enhance access to biologic therapies for postmenopausal women with osteoporosis. The inclusion of biosimilar denosumab in national osteoporosis management programs could lead to increased uptake, but it is not explored in this analysis and requires further consideration.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01752-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a national reimbursement policy for secondary fracture prevention on early secondary fractures after hip fracture surgery in Japan: a nationwide interrupted time series analysis","authors":"Yoshinori Hiyama","doi":"10.1007/s11657-026-01759-w","DOIUrl":"10.1007/s11657-026-01759-w","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>A national reimbursement scheme aimed to enhance secondary fracture prevention after hip fracture. Although prevention processes improved substantially, early secondary fracture incidence did not clearly decline. Differential effects by hospital payment system suggest that financial incentives alone may be insufficient and that organizational readiness and care pathways may influence impact.</p><h3>Purpose</h3><p>In 2022, Japan introduced a reimbursement scheme to promote secondary fracture prevention (SFP) after hip fracture. We examined whether this implementation was associated with a reduction in secondary major osteoporotic fractures within 6 months after hip fracture surgery at the national level.</p><h3>Methods</h3><p>We conducted a nationwide interrupted time series analysis including adults aged 60 years or older who underwent surgery for hip fracture between April 2017 and February 2023. The primary outcome was the monthly estimated 6-month cumulative incidence of secondary major osteoporotic fractures. Process measures included osteoporosis assessment, initiation of guideline-recommended osteoporosis medication, and receipt of both during the index hospitalization. Effect modification by hospital payment system (Diagnosis Procedure Combination [DPC] versus non-DPC) was examined.</p><h3>Results</h3><p>Among 127,676 patients, the introduction of the SFP management fee was associated with substantial immediate and sustained increases in osteoporosis assessment and medication initiation during the index hospitalization. However, no clear immediate change or change in trend in the 6-month cumulative incidence of secondary fractures was observed at the national level. In contrast, a greater post-introduction decline in secondary fracture incidence was observed in DPC hospitals compared with non-DPC hospitals.</p><h3>Conclusion</h3><p>Although the SFP reimbursement scheme improved in-hospital SFP processes after hip fracture, it was not associated with a clear national-level reduction in secondary fractures within 6 months. Differences by hospital characteristics suggest that organizational capacity and established care pathways may influence how reimbursement incentives translate into clinical benefit.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keeping bone resorption markers very low for 1 year after denosumab prevents bone loss at 2 years: the ReoLaus study","authors":"Giovanni Liebich,&nbsp;Olivier Lamy,&nbsp;Jérôme Pasquier,&nbsp;Elena Gonzalez-Rodriguez","doi":"10.1007/s11657-026-01747-0","DOIUrl":"10.1007/s11657-026-01747-0","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>BMD loss is common after denosumab discontinuation, and longer treatment is associated with greater BMD loss. Serum crosslaps (sCTX) can predict BMD loss at the lumbar spine after discontinuation. Keeping sCTX below the lower half of the ULN during the first year is needed to avoid BMD loss at 2 years.</p><h3>Context</h3><p>After denosumab discontinuation (DD), elevated serum crosslaps (sCTX) is associated with bone mineral density (BMD) loss over 2 years. Bisphosphonates reduce but do not always prevent this loss.</p><h3>Objective</h3><p>To define an sCTX threshold below which BMD is maintained after DD.</p><h3>Methods</h3><p>Postmenopausal women receiving ≥ 2 denosumab doses and followed ≥ 2 years after DD with regular BMD and sCTX measurements were included retrospectively. Linear regression analysis and ROC curves were performed to define sCTX threshold (%ULN, upper limit of the norm in premenopausal women) preventing 1- and 2-year lumbar spine (LS) BMD loss.</p><h3>Results</h3><p>From 161 women who had received 8.0 ± 2.9 injections, 50% lost BMD after 2 years. BMD at DD were similar at all sites in non-losers and losers’ groups but losers had received more injections. Their T-score decreased after 1 and 2 years (<i>p</i> &lt; 0.001). BMD loss was highly correlated with increased sCTX during both periods. After DD, first-year sCTX levels predicted 1- and 2-year LS BMD loss. The optimal sCTX thresholds during the first year to avoid LS BMD loss at 1 and 2 years were 69% and 49% ULN; for 100% sensitivity, they were 32% and 23% ULN, respectively. Losers received more often ≥ 3 zoledronate infusions and were less treated with alendronate only.</p><h3>Conclusion</h3><p>sCTX level during the first year after DD predict 1- and 2-year LS BMD loss. Keeping sCTX below the lower half of the ULN during the first year is needed to avoid BMD loss. Despite high bisphosphonates doses, it is not always possible to reach this target.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}