More widespread vertebral bone accrual seen with romosozumab than teriparatide
Click Here to Manage Email Alerts
Postmenopausal women experienced more widespread vertebral bone accrual at the lumbar spine at 12 months of romosozumab treatment compared with teriparatide, according to study data published in the Journal of Bone and Mineral Research.
In findings from a quantitative CT substudy, researchers observed greater increases in cortical thickness, endocortical thickness, cortical bone mineral density and cortical mass surface density at the lumbar spine among women assigned romosozumab-aqqg (Evenity, Amgen) compared with teriparatide (Forteo, Eli Lilly; Bonsity, Alvogen) due to greater bone accrual in fracture-prone areas of the vertebral shell and endplates.
“Three-dimensional vertebral bone mapping is a great technique to show bone accrual in the vertebrae of women with low bone density followed for a year,” Kenneth Poole, BM, FRCP, PhD, professor of metabolic bone disease at the University of Cambridge and the Cambridge NIHR Biomedical Research Centre, U.K., told Healio. “Romosozumab shows striking, rapid gains in vertebral bone structure. The color map images can give patients, clinicians and researchers a very clear view of where bone accrual occurs after the single course of romosozumab pen injections.”
Poole and colleagues analyzed data from 56 postmenopausal women aged 55 to 85 years participating in a quantitative CT substudy of a randomized, placebo-controlled, parallel-group phase 2 study. Participants were randomly assigned to 210 mg romosozumab injections monthly (n = 17), 20 mg open-label teriparatide daily (n = 19) or placebo (n = 20). Quantitative CT scans were analyzed at baseline and 12-month follow-up. Cortical thickness, endocortical thickness, cortical BMD, cancellous BMD and cortical mass surface density were measured for each participant. Color maps of the changes in the lumbar vertebrae were analyzed and visualized on the bone surface.
At 12 months, the romosozumab group had significantly greater increases compared with the teriparatide group in cortical thickness (10.3% vs. 4.3%), cortical BMD (2.1% vs. –0.1%) and endocortical thickness (137.6% vs. 47.5%). There was no significant difference between the two groups in cancellous BMD. Women in the placebo group had no significant changes in any measurements except for cancellous BMD, which declined 4.6% at 12 months.
Analysis of the cortical maps revealed increases in cortical thickness, cortical BMD and cortical mass surface density predominantly at the vertebral shell for the teriparatide group. The romosozumab group had increases in all areas, including in fracture-prone areas of the vertebral shell and endplates.
“I was surprised at how extensive the vertebral bone accrual was after the 12-month course of romosozumab, particularly the bone accrual at the vertebral endplates, which tend to give way in a fracture,” Poole said. “We didn’t see the same pattern by 12 months with teriparatide, a drug which is prescribed for a longer 18 to 24 months course for patients attending my clinics at Addenbrooke’s Hospital.”
The researchers wrote that further studies are needed to relate the vertebral bone changes to the risk for fracture.
For more information:
Kenneth Poole, BM, FRCP, PhD, can be reached at kp254@medschl.cam.ac.uk.
Collapse
Read more about
Click Here to Manage Email Alerts