Osteoporos Sarcopenia. 2025 Dec;11(4):137-144. doi: 10.1016/j.afos.2025.11.002. Epub 2025 Nov 29.
ABSTRACT
OBJECTIVES: The effectiveness of combining romosozumab (ROMO) with denosumab (Dmab) remains uncertain. We compare the six-month effects of Dmab plus monthly ROMO versus Dmab plus daily teriparatide (TPTD) on bone mineral density (BMD) in treatment-naïve postmenopausal women with osteoporosis.
METHODS: This retrospective cohort study analyzed 26 treatment-naïve postmenopausal women with primary osteoporosis. Participants received either a monthly regimen of ROMO and Dmab (N = 14) or a daily regimen of TPTD plus Dmab (N = 12). BMD at the lumbar spine, total hip, and femoral neck was measured at baseline, 3 months, and 6 months by dual-energy X-ray absorptiometry. Serum levels of C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP) were assessed at the same intervals.
RESULTS: Both regimens significantly improved lumbar spine BMD at 6 months (ROMO + Dmab: +9.75%; TPTD + Dmab: +7.42%). Improvements in total hip and femoral neck BMD were modest and similar between groups (∼2%). Serum CTX and P1NP were significantly suppressed in both groups at 3 months, but P1NP suppression waned in the TPTD + Dmab group by 6 months. No statistically significant differences in BMD or marker changes were detected between the two regimens.
CONCLUSIONS: Both combination therapies effectively improve lumbar spine BMD over 6 months. The ROMO + Dmab regimen yielded numerically greater increases with fewer injections.
PMID:41498097 | PMC:PMC12766607 | DOI:10.1016/j.afos.2025.11.002
