Osteoporosis, bone & mineral

A new age of osteoanabolic therapy? A real-world, two-centre study comparing effects of romosozumab, teriparatide, and antiresorptive therapies for osteoporosis

Osteoporos IntPublished Retrospective cohort study

Authors' conclusion

Romosozumab provides real-world efficacy in BMD improvement, particularly at the LS, with significantly greater gains than those seen with teriparatide or standard therapies.

Study context

Population
Patients with osteoporosis treated at tertiary hospitals in Australia, 2021–23
Participants
53 / 54 / 60
Exposure
Romosozumab vs teriparatide vs antiresorptive therapy
  • Romosozumabn = 53
  • Teriparatiden = 54
  • Anti-resorptiven = 60reference
Outcome
Change in BMD (LS, TH, FN, wrist)
Follow-up
12 months
Methodological detailstwo-centre, real-world
  • Two-centre
  • Real-world

Main finding

As reported in the abstract

Mean LS BMD gain

Romosozumab vs Teriparatide: P < 0.001 · Romosozumab vs Anti-resorptive: P < 0.001

Romosozumab increased bone mineral density (BMD) at lumbar spine (LS), total hip (TH) and femoral neck (FN), with a decrease at the wrist
P < 0.05

Observational data: associations, not effects.

Further findings

LS BMD gain on romosozumab, treatment-naïve vs prior anti-resorptive (subgroup)

P = 0.220

TH BMD gain on romosozumab, treatment-naïve vs prior anti-resorptive (subgroup)

P = 0.009

Correlation of prior anti-resorptive duration with LS BMD gain on romosozumab

R
- 0.305
P
P = 0.026

Linear regression of LS BMD response

More vertebral fractures, longer prior anti-resorptive use and higher baseline LS BMD each attenuated LS BMD response to romosozumab; romosozumab outperformed teriparatide and anti-resorptives; teriparatide showed no significant difference from anti-resorptives

Original publication

A new age of osteoanabolic therapy? A real-world, two-centre study comparing effects of romosozumab, teriparatide, and antiresorptive therapies for osteoporosis. Osteoporos Int. Published 20 March 2026. doi:10.1007/s00198-025-07808-3

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