Effects of romosozumab on the peripheral and axial skeleton in postmenopausal women at high fracture risk: real-world evidence from DXA and high-resolution peripheral quantitative CT (HR-pQCT) data
Authors' conclusion
After 12 months of ROMO treatment, aBMD increased significantly at the lumbar spine and total hip, while volumetric BMD, microarchitecture, and strength at the peripheral skeleton did not change or deteriorated.
Study context
- Population
- Postmenopausal women at high fracture risk, regular hospital care
- Participants
- 28 vs 55
- Exposure
- Romosozumab vs bisphosphonate treatment
- ROMOn = 28
- Bisphosphonate (BP)n = 55reference
- Outcome
- Change in aBMD (DXA) and HR-pQCT parameters with ROMO, T0 to T1
- Follow-up
- 12 months
Methodological detailsreal-world data, single-centre, age-matched comparison cohort
- Real-world data
- Single-centre
- Age-matched comparison cohort
Main finding
As reported in the abstract
12 months
- Lumbar spine areal bone mineral density (aBMD) change: +9.6% [IQR = 6.6,15.7]
- p < 0.001
- Total hip aBMD change: +4.4 ± 5.8%
- p = 0.001
- Distal radius total volumetric BMD change: −2.4%, [−4.3,−0.1]
- p = 0.004
- Distal radius trabecular volumetric BMD change: −1.7%, [−3.5,0.5]
- p = 0.013
Observational data: associations, not effects.
Further findings
HR-pQCT changes, ROMO vs BP cohort · 12 months
- Most HR-pQCT changes did not significantly differ from those in the BP cohort
Baseline (T0) aBMD T-scores, ROMO
- Lumbar spine T-score
- −2.3 ± 1.6
- Total hip T-score
- −2.1 ± 0.7
- Femoral neck T-score
- −2.7 ± 0.5
- ROMO: 72.4 ± 7.6 years, 67.9% treatment-naïve
Original publication
Effects of romosozumab on the peripheral and axial skeleton in postmenopausal women at high fracture risk: real-world evidence from DXA and HR-pQCT data. Osteoporos Int. Published 9 September 2026. doi:10.
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