Osteoporosis, bone & mineral

3D-DXA reveals significant effects of burosumab on trabecular and cortical skeletal envelopes in symptomatic adults with X-linked hypophosphatemia

J Bone Miner ResPublished Prospective single-group substudy of the burosumab registration trial

Authors' conclusion

These data demonstrate that burosumab increases both cortical and trabecular bone in the hip, a site of frequent fracture in XLH.

Study context

Population
Symptomatic adults with X-linked hypophosphatemia (XLH), volunteers from the registration trial for burosumab
Participants
20 adults
Comparison
Burosumab: end of treatment vs baseline
  • Burosumabn = 20
Methodological details3D-DXA analysis, DXA hip scans before and 6, 12 and 18-24 mo after therapy; 3D-Shaper software
  • 3D-DXA analysis
  • DXA hip scans before and 6, 12 and 18-24 mo after therapy; 3D-Shaper software

Primary result

As reported in the abstract

Trabecular vBMD change from baseline · end of treatment

TH trabecular volumetric BMD (vBMD) increase vs baseline (p < .0001)

13.6%

FN trabecular vBMD increase vs baseline (p < .0001)

14.1%

Further findings

FN cortical surface BMD (sBMD)

Significant increase between 6 and 12 mo
P < 0.05
Significant increase between 6 and 18-24 mo
P < 0.05

FN cross-sectional moment of inertia (CSMI) (indicator of FN strength) vs baseline

Significant increase at 12 mo
P < 0.05
Significant increase at 18-24 mo
P < 0.01

Original publication

3D-DXA reveals significant effects of burosumab on trabecular and cortical skeletal envelopes in symptomatic adults with X-linked hypophosphatemia. J Bone Miner Res. Published 13 July 2025. doi:10.1093/jbmr/zjaf092

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