The clinical update offers a concise overview of recently published, high-impact journal articles that may influence clinical practice, summarized for our readers. This edition highlights recent studies related to the diagnosis and management of osteoporosis. It reviews essential international guidelines on the clinical use of trabecular bone score (TBS) and a goal-oriented approach to treatment, alongside emerging data on the cardiovascular safety of romosozumab and evidence underscoring the underuse of zoledronate. In particular, it discusses the limited utilization of zoledronate in early postmenopausal women and its inpatient use in older adults after hip fractures.
SchuitSCE, van der KliftM, WeelAEAM, et al.Fracture incidence and association with bone mineral density in elderly men and women: The Rotterdam Study. Bone, 2004; 34(1):195–202; doi: 10.1016/j.bone.2003.10.001
2.
HansD, GoertzenAL, KriegM-A, et al.Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: The Manitoba study. J Bone Miner Res, 2011; 26(11):2762–2769; doi: 10.1002/jbmr.499
3.
HarveyNC, GlüerCC, BinkleyN, et al.Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice. Bone, 2015; 78:216–224; doi: 10.1016/j.bone.2015.05.016
4.
ShevrojaE, ReginsterJ-Y, LamyO, et al.Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: Results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging. Osteoporosis. Osteoporos Int, 2023; 34(9):1501–1529; doi: 10.1007/s00198-023-06817-4
5.
SilvaBC, LeslieWD, ReschH, et al.Trabecular bone score: A noninvasive analytical method based upon the DXA image. J Bone Miner Res, 2014; 29(3):518–530; doi: 10.1002/jbmr.2176
6.
McCloskeyEV, OdénA, HarveyNC, et al.A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. Journal of Bone and Mineral Research : The Official Journal of the American Society for Bone and Mineral Research, 2016; 31(5):940–948; doi: 10.1002/jbmr.2734
7.
SaagKG, ShaneE, BoonenS, et al.Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med, 2007; 357(20):2028–2039; doi: 10.1056/NEJMoa071408
8.
KendlerDL, MarinF, ZerbiniCAF, et al.Effects of teriparatide and risedronate on new fractures in post-menopausal women with severe osteoporosis (VERO): A multicentre, double-blind, double-dummy, randomised controlled trial. Lancet, 2018; 391(10117):230–240; doi: 10.1016/S0140-6736(17)32137-2
9.
LederBZ, MitlakB, HuM-Y, et al.Effect of abaloparatide vs alendronate on fracture risk reduction in postmenopausal women with osteoporosis. J Clin Endocrinol Metab, 2020; 105(3):938–943; doi: 10.1210/clinem/dgz162
10.
CosmanF, OatesM, BetahD, et al.Romosozumab followed by denosumab versus denosumab only: A post hoc analysis of FRAME and FRAME extension. J Bone Miner Res, 2024; 39(9):1268–1277; doi: 10.1093/jbmr/zjae116
CosmanF, NievesJW, DempsterDW. Treatment sequence matters: Anabolic and antiresorptive therapy for osteoporosis. J Bone Miner Res, 2017; 32(2):198–202; doi: 10.1002/jbmr.3051
13.
McClungMR, GrauerA, BoonenS, et al.Romosozumab in postmenopausal women with low bone mineral density. N Engl J Med, 2014; 370(5):412–420; doi: 10.1056/NEJMoa1305224
14.
Amgen Inc. Evenity (Romosozumab-Aqqg) Injection, for Subcutaneous Use. AMGEN: Thousand Oaks, CA; 2019.
15.
CosmanF, CrittendenDB, AdachiJD, et al.Romosozumab treatment in postmenopausal women with osteoporosis. N Engl J Med, 2016; 375(16):1532–1543; doi: 10.1056/NEJMoa1607948
16.
SaagKG, PetersenJ, BrandiML, et al.Romosozumab or alendronate for fracture prevention in women with osteoporosis. N Engl J Med, 2017; 377(15):1417–1427; doi: 10.1056/NEJMoa1708322
GreyA, BollandMJ, HorneA, et al.Five years of anti-resorptive activity after a single dose of zoledronate–results from a randomized double-blind placebo-controlled trial. Bone, 2012; 50(6):1389–1393; doi: 10.1016/j.bone.2012.03.016
19.
GreyA, BollandMJ, HorneA, et al.Bone mineral density and bone turnover 10 years after a single 5 mg dose or two 5-yearly lower doses of zoledronate in osteopenic older women: An open-label extension of a randomized controlled trial. J Bone Miner Res, 2022; 37(1):3–11; doi: 10.1002/jbmr.4453
20.
TranT, BliucD, HansenL, et al.Persistence of excess mortality following individual nonhip fractures: a relative survival analysis. J Clin Endocrinol Metab, 2018; 103(9):3205–3214; doi: 10.1210/jc.2017-02656
21.
SingC-W, LinT-C, BartholomewS, et al.Global epidemiology of hip fractures: Secular trends in incidence rate, post-fracture treatment, and all-cause mortality. J Bone Miner Res, 2023; 38(8):1064–1075; doi: 10.1002/jbmr.4821
22.
KanisJA, SvedbomA, HarveyN, et al.The osteoporosis treatment gap. J Bone Miner Res, 2014; 29(9):1926–1928; doi: 10.1002/jbmr.2301
23.
LylesKW, Colón-EmericCS, MagazinerJS, et al.; HORIZON Recurrent Fracture Trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med, 2007; 357(18):1799–1809; doi: 10.1056/NEJMoa074941
24.
FanW, MachadoM, LederBZ, et al.Inpatient zoledronic acid and integrated orthopedic and fracture liaison services improve osteoporosis treatment rates. J Clin Endocrinol Metab, 2022; 108(1):191–197; doi: 10.1210/clinem/dgac508
25.
GaoY, LiuX, GuY, et al.The effect of bisphosphonates on fracture healing time and changes in bone mass density: A meta-analysis. Front Endocrinol, 2021; 12; doi: 10.3389/fendo.2021.688269
