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Effects of anti-resorptive agents on trabecular bone score (TBS) in older women

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Abstract

Summary

We evaluated the longitudinal effects of anti-resorptive agents (534 treated women vs. 1,150 untreated) on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). TBS was responsive to treatment in women over age 50. The treatment-related increase in TBS was less than the increase in BMD, which is consistent with bone texture preservation.

Introduction

In addition to inducing an increase in BMD, anti-resorptive agents also help to preserve bone architecture. TBS, a new gray-level texture measurement, correlates with 3D parameters of bone micro-architecture independent of BMD. Our objective was to evaluate the longitudinal effects of anti-resorptive agents on lumbar spine BMD and TBS.

Methods

Women (≥50 years), from the BMD program database for the province of Manitoba, Canada, who had not received any anti-resorptive drug prior to their initial dual X-ray absorptiometry (DXA) exam were divided into two groups: untreated, those without any anti-resorptive drug over the course of follow-up, and treated, those with a non-estrogen anti-resorptive drug (86 % bisphosphonates, 10 % raloxifene, and 4 % calcitonin). Lumbar spine TBS was calculated for each lumbar spine DXA examination. Changes in TBS and BMD between baseline and follow-up (mean follow-up 3.7 years), expressed in percentage per year, were compared between the two groups.

Results

A total of 1,150 untreated women and 534 treated women met the inclusion criteria. Only a weak correlation was seen between BMD and TBS in either group. Significant intergroup differences in BMD change and TBS change were observed over the course of follow-up (p < 0.001). Similar mean decreases in BMD and TBS (−0.36 %/year and −0.31 %/year, respectively) were seen for untreated subjects (both p < 0.001). Conversely, treated subjects exhibited a significant mean increase in BMD (+1.86 %/year, p < 0.002) and TBS (+0.20 %/year, p < 0.001).

Conclusion

TBS is responsive to treatment with non-estrogen anti-resorptive drug therapy in women over age 50. The treatment-related increase in TBS is less than the increase in BMD, which is consistent with bone texture preservation.

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Acknowledgments

The authors are indebted to Manitoba Health for providing data that are essential to this study (HIPC file no. 2008/2009-033). We note, however, that the results and conclusions are those of the authors, and no official endorsement by Manitoba Health is intended or should be inferred. This work has been reviewed and approved by the Manitoba Bone Density Program Committee.

Conflicts of interest

Didier Hans is co-owner of the TBS patent and has corresponding ownership shares. All the other authors state that they have no conflicts of interest.

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Authors and Affiliations

  1. Bone Diseases Unit, DAL, Lausanne University Hospital, Avenue Pierre-Decker 4, 1011, Lausanne, Switzerland

    M. A. Krieg, B. Aubry-Rozier & D. Hans

  2. Faculty of Medicine, University of Manitoba, Winnipeg, Canada

    W. D. Leslie

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  1. M. A. Krieg
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  2. B. Aubry-Rozier
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  3. D. Hans
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  4. W. D. Leslie
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for the Manitoba Bone Density Program

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Correspondence to D. Hans.

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Krieg, M.A., Aubry-Rozier, B., Hans, D. et al. Effects of anti-resorptive agents on trabecular bone score (TBS) in older women. Osteoporos Int 24, 1073–1078 (2013). https://doi.org/10.1007/s00198-012-2155-y

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  • DOI: https://doi.org/10.1007/s00198-012-2155-y

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