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.