To investigate the impact of baseline total N-terminal propeptide of procollagen (PINP) levels on increases in bone mineral density (BMD) after treatment with romosozumab (ROMO), teriparatide (TPTD), and denosumab (DMAb) in patients with treatment naïve primary osteoporosis. This multicenter, retrospective cohort study included 462 treatment-naïve patients (88.7 % female; mean age, 75.5 years; baseline BMD T-scores: lumbar spine LS, -3.0; total hip TH, -2.7) who initiated treatment with ROMO (n = 310), TPTD (n = 70), or DMAb (n = 82). Patients were stratified by baseline total PINP levels into low (≤ 70.1 μg/L) and high (> 70.1 μg/L) groups. After adjusting for baseline characteristics using inverse probability of treatment weighting, changes in BMD were evaluated at 12 months. In the low PINP group, increases in LS BMD were similar between ROMO and TPTD; in the high PINP group, ROMO led to greater increases in LS BMD than TPTD. ROMO resulted in greater increases in TH BMD than TPTD, regardless of PINP level. Compared with DMAb, ROMO resulted in greater increases in LS BMD and TH BMD in the low PINP group, whereas no significant differences were observed in the high PINP group. ROMO demonstrated robust increases in both LS and TH BMD across all PINP levels. TPTD led to increases in LS BMD comparable to those with ROMO in the low PINP group. DMAb led to increases in both LS and TH BMD comparable to those with ROMO in the high PINP group.
Etani et al. (Mon,) studied this question.
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