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Introduction <p>Spinal osteoporosis is a prevalent skeletal disorder characterized by decreased bone mass and increased fracture risk. The combination of teriparatide and denosumab has shown promise in improving bone health by promoting bone formation and suppressing bone resorption. However, the effects of this combination treatment on trabecular bony strength in spinal osteoporosis remain unclear. The purpose of this study was to determine the effect of combination therapy of denosumab and teriparatide on volumetric bone mineral density as assessed by Quantitative Computed Tomography (QCT) in the lumbar spine.</p> Methods <p>Fifty patients (average age: 67.5&#xa0;years) who underwent treatment at our center for osteoporosis as diagnosed by QCT between Jan 2019 and March 2023 were included in this study. Retrospective analysis of a prospective database was performed. This database included information about patients’ demographic details and pre-treatment QCT scores, adherence to treatment and post-treatment QCT scores. Only patients who completed a full 18&#xa0;months of treatment with combination of daily teriparatide (20&#xa0;µg) and 6-monthly denosumab (60&#xa0;mg) and had 80% adherence to teriparatide were included in this study.</p> Results <p>Following the combination treatment for 18&#xa0;months, the mean intra-treatment QCT T score (measured at an average of 6&#xa0;months after completion of treatment with teriparatide) improved from −&#xa0;3.81 to −&#xa0;2.48 (p &lt; 0.001), and the average trabecular bone density improved from 68.08 to 97.22&#xa0;mg/cm<sup>3</sup>, a 54.9% increase (p &lt; 0.001). The treatment was well-tolerated, with no serious adverse events reported.</p> Conclusion <p>Combination therapy of teriparatide (20&#xa0;µg) daily and 6 monthly denosumab (60&#xa0;mg) demonstrates an improvement in the trabecular bone density in this small group of patients. The limitations of this study include a small sample size and an absence of analysis of bone turnover marker. Further research in the form of clinical trials should be conducted to affirm the efficacy of this treatment regimen and compare it to other treatment regimens.</p>

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Change in vBMD of Combination Therapy of Teriparatide and Denosumab in Osteoporosis at 18 Months: How Much Difference Does It Make on Spine vBMD?

  • 期刊论文

  • 发表日期：

    2026年2月17日

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  • Arvind G. Kulkarni,
  • Sunil Chodavadiya,
  • Aniruddh Agrawal,
  • Priyambada Kumar,
  • Sunila Jaggi,
  • Sonali Shah

摘要

Introduction

Spinal osteoporosis is a prevalent skeletal disorder characterized by decreased bone mass and increased fracture risk. The combination of teriparatide and denosumab has shown promise in improving bone health by promoting bone formation and suppressing bone resorption. However, the effects of this combination treatment on trabecular bony strength in spinal osteoporosis remain unclear. The purpose of this study was to determine the effect of combination therapy of denosumab and teriparatide on volumetric bone mineral density as assessed by Quantitative Computed Tomography (QCT) in the lumbar spine.

Methods

Fifty patients (average age: 67.5 years) who underwent treatment at our center for osteoporosis as diagnosed by QCT between Jan 2019 and March 2023 were included in this study. Retrospective analysis of a prospective database was performed. This database included information about patients’ demographic details and pre-treatment QCT scores, adherence to treatment and post-treatment QCT scores. Only patients who completed a full 18 months of treatment with combination of daily teriparatide (20 µg) and 6-monthly denosumab (60 mg) and had 80% adherence to teriparatide were included in this study.

Results

Following the combination treatment for 18 months, the mean intra-treatment QCT T score (measured at an average of 6 months after completion of treatment with teriparatide) improved from − 3.81 to − 2.48 (p < 0.001), and the average trabecular bone density improved from 68.08 to 97.22 mg/cm3, a 54.9% increase (p < 0.001). The treatment was well-tolerated, with no serious adverse events reported.

Conclusion

Combination therapy of teriparatide (20 µg) daily and 6 monthly denosumab (60 mg) demonstrates an improvement in the trabecular bone density in this small group of patients. The limitations of this study include a small sample size and an absence of analysis of bone turnover marker. Further research in the form of clinical trials should be conducted to affirm the efficacy of this treatment regimen and compare it to other treatment regimens.