Comparison between different bone treatments on areal bone mineral density (aBMD) and bone microarchitectural texture as assessed by the trabecular bone score (TBS)

- Osteoporotic treatment effects on men and women
- Differentiating effect of osteoporotic treatments on TBS and aBMD
- Preservation of aBMD and TBS in patient with Calcium and Vitamin D supplementation

PurposeThe objective of the study was to assess longitudinal effects of different osteoporosis treatments on TBS and aBMD at lumbar spine.MethodWe analyzed 390 patients (men: 72; women: 318; age > 40 years; mean follow-up of 20 months and BMI < 37 kg/m2). We stratified the cohort by treatments: Naive of treatment (Naive, n = 67), Calcium and Vitamin D (CaVitD, n = 87), Testosterone (Te, n = 36), Alendronate (AL, n = 88), Risedronate (Ri, n = 39), Denosumab (Dmb, n = 43) and Teriparatide (PTH, n = 30). The follow-up changes from baseline were normalized at 24 months.ResultsAfter 24 months, Naive group TBS decreased by 3.1% (p < 0.05) whereas a non-significant increase was observed for spine aBMD (Δ = + 0.5%). Compared to the Naive group, significant improvement (p < 0.05) was observed in both TBS and aBMD for Te, AL, Ri, Dmb and PTH groups and in the CaVitD group for TBS. At the end of the follow-up, significant improvement have been observed for aBMD in Te (+ 4.4%), AL (+ 4.1%), Ri (+ 4.8), D (+ 8.8%) and PTH (+ 8.8%) groups. Significant improvement was observed only in the AL (+ 1.4%), Dmb (+ 2.8%) and PTH (+ 3.6%) groups for TBS.ConclusionAs expected, TBS of Naive subjects decreased with age. As expected a TBS preservation has been observed under AL and Ri. Te and CaVitD effects on TBS were evaluated for the first time: a similar preservation effect has been observed. A significant TBS increase was observed under Denosumab and PTH. TBS could be a useful tool to monitor treatment effects.