Osteoporosis International

, Volume 28, Issue 10, pp 2967–2973 | Cite as

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

  • M. R. McClung
  • K. Lippuner
  • M. L. Brandi
  • J. R. Zanchetta
  • H. G. Bone
  • R. Chapurlat
  • D. Hans
  • A. Wang
  • C. Zapalowski
  • C. Libanati
Original Article

Abstract

Summary

Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis.

Introduction

TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM.

Methods

Postmenopausal women with lumbar spine or total hip BMD T-score <−2.5 and −4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit.

Results

Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was −2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r2 ≤ 0.06).

Conclusions

In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD.

Keywords

Denosumab Postmenopausal women Trabecular bone score 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  • M. R. McClung
    • 1
    • 2
  • K. Lippuner
    • 3
  • M. L. Brandi
    • 4
  • J. R. Zanchetta
    • 5
  • H. G. Bone
    • 6
  • R. Chapurlat
    • 7
  • D. Hans
    • 8
  • A. Wang
    • 9
  • C. Zapalowski
    • 9
    • 10
  • C. Libanati
    • 9
    • 11
  1. 1.Oregon Osteoporosis CenterPortlandUSA
  2. 2.Institute for Health and Ageing, Australian Catholic UniversityMelbourneAustralia
  3. 3.University of BerneBerneSwitzerland
  4. 4.University of FlorenceFlorenceItaly
  5. 5.Instituto de Investigaciones MetabólicasBuenos AiresArgentina
  6. 6.Michigan Bone and Mineral ClinicDetroitUSA
  7. 7.INSERM UMR 1033, Université de Lyon, Hôpital Edouard HerriotLyonFrance
  8. 8.Lausanne University Hospital, Center of Bone DiseasesLausanneSwitzerland
  9. 9.Amgen Inc.Thousand OaksUSA
  10. 10.Radius HealthWalthamUSA
  11. 11.UCB PharmaBrusselsBelgium

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