» Articles » PMID: 38477808

3D-modeling from Hip DXA Shows Improved Bone Structure with Romosozumab Followed by Denosumab or Alendronate

Overview
Date 2024 Mar 13
PMID 38477808
Authors
Affiliations
Soon will be listed here.
Abstract

Romosozumab treatment in women with postmenopausal osteoporosis increases bone formation while decreasing bone resorption, resulting in large BMD gains to reduce fracture risk within 1 yr. DXA-based 3D modeling of the hip was used to assess estimated changes in cortical and trabecular bone parameters and map the distribution of 3D changes in bone parameters over time in patients from 2 randomized controlled clinical trials: FRAME (romosozumab vs placebo followed by denosumab) and ARCH (romosozumab vs alendronate followed by alendronate). For each study, data from a subset of ~200 women per treatment group who had TH DXA scans at baseline and months 12 and 24 and had provided consent for future research were analyzed post hoc. 3D-SHAPER software v2.11 (3D-SHAPER Medical) was used to generate patient-specific 3D models from TH DXA scans. Percentage changes from baseline to months 12 and 24 in areal BMD (aBMD), integral volumetric BMD (vBMD), cortical thickness, cortical vBMD, cortical surface BMD (sBMD), and trabecular vBMD were evaluated. Data from 377 women from FRAME (placebo, 190; romosozumab, 187) and 368 women from ARCH (alendronate, 185; romosozumab, 183) with evaluable 3D assessments at baseline and months 12 and 24 were analyzed. At month 12, treatment with romosozumab vs placebo in FRAME and romosozumab vs alendronate in ARCH resulted in greater increases in aBMD, integral vBMD, cortical thickness, cortical vBMD, cortical sBMD, and trabecular vBMD (P < .05 for all). At month 24, cumulative gains in all parameters were greater in the romosozumab-to-denosumab vs placebo-to-denosumab sequence and romosozumab-to-alendronate vs alendronate-to-alendronate sequence (P < .05 for all). 3D-SHAPER analysis provides a novel technique for estimating changes in cortical and trabecular parameters from standard hip DXA images. These data add to the accumulating evidence that romosozumab improves hip bone density and structure, thereby contributing to the antifracture efficacy of the drug.

Citing Articles

Use of 3D-DXA in the assessment of bone structure among patients with chronic kidney disease.

Kuzma M, Kuzmova Z, Humbert L, Picazo M, Kralik R, Falat J Front Med (Lausanne). 2025; 12:1471418.

PMID: 39967597 PMC: 11832544. DOI: 10.3389/fmed.2025.1471418.


Age- and Sex-Related Volumetric Density Differences in Trabecular and Cortical Bone of the Proximal Femur in Healthy Population.

Brance M, Saravi F, Henriquez M, Larroude M, Jacobo J, Araujo S J Bone Metab. 2024; 31(4):279-289.

PMID: 39701108 PMC: 11658838. DOI: 10.11005/jbm.24.765.


A practical approach for anabolic treatment of bone fragility with romosozumab.

Cianferotti L, Cipriani C, Palermo A, Viapiana O, Zavatta G, Mazziotti G J Endocrinol Invest. 2024; 47(11):2649-2662.

PMID: 38789679 DOI: 10.1007/s40618-024-02395-2.

References
1.
Johnell O, Kanis J . An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006; 17(12):1726-33. DOI: 10.1007/s00198-006-0172-4. View

2.
Kendler D, Marin F, Zerbini C, Russo L, Greenspan S, Zikan V . Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet. 2017; 391(10117):230-240. DOI: 10.1016/S0140-6736(17)32137-2. View

3.
Humbert L, Martelli Y, Fonolla R, Steghofer M, Di Gregorio S, Malouf J . 3D-DXA: Assessing the Femoral Shape, the Trabecular Macrostructure and the Cortex in 3D from DXA images. IEEE Trans Med Imaging. 2016; 36(1):27-39. DOI: 10.1109/TMI.2016.2593346. View

4.
Brown J, Engelke K, Keaveny T, Chines A, Chapurlat R, Foldes A . Romosozumab improves lumbar spine bone mass and bone strength parameters relative to alendronate in postmenopausal women: results from the Active-Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) trial. J Bone Miner Res. 2021; 36(11):2139-2152. PMC: 9292813. DOI: 10.1002/jbmr.4409. View

5.
Genant H, Engelke K, Bolognese M, Mautalen C, Brown J, Recknor C . Effects of Romosozumab Compared With Teriparatide on Bone Density and Mass at the Spine and Hip in Postmenopausal Women With Low Bone Mass. J Bone Miner Res. 2016; 32(1):181-187. DOI: 10.1002/jbmr.2932. View