Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2-year open-label study

Senn, Christoph; Günther, B; Popp, Albrecht; Perrelet, Romain; Hans, Didier; Lippuner, Kurt

doi:10.1007/s00198-014-2703-8

Cited by 80 publications

(67 citation statements)

References 46 publications

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“…The change in TBS also appears to be influenced by the type of therapy for osteoporosis. Previous studies have reported greater improvement in TBS with an anabolic therapy such as teriparatide compared with a bisphosphonate [37,38]. In this study, denosumab was associated with significantly greater improvement in TBS than placebo at each of the annual assessments.…”

Section: Discussionmentioning

confidence: 44%

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

McClung¹,

Lippuner²,

Brandi³

et al. 2017

Osteoporos Int

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Summary Trabecular bone score (TBS) assesses bone quality in the lumbar spine using dual-energy X-ray absorptiometry (DXA) scans. In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of bone mineral density (BMD). This practical technique may have a role in managing patients with osteoporosis. Introduction TBS, a gray-level texture index determined from lumbar spine DXA scans, correlates with bone microarchitecture and enhances assessment of vertebral fracture risk independently of BMD. In the FREEDOM study, denosumab increased BMD and reduced new vertebral fractures in postmenopausal women with osteoporosis. This retrospective analysis explored the effect of denosumab on TBS and the association between TBS and BMD in FREEDOM. Methods Postmenopausal women with lumbar spine or total hip BMD T-score <−2.5 and −4.0 or higher at both sites received placebo or denosumab 60 mg subcutaneously every 6 months. TBS indices were determined from DXA scans at baseline and months 12, 24, and 36 in a subset of 285 women (128 placebo, 157 denosumab) who had TBS values at baseline and ≥1 postbaseline visit. Results Baseline characteristics were comparable between treatment groups; mean (SD) lumbar spine BMD T-score was −2.79 (0.64), and mean (standard deviation [SD]) TBS was 1.200 (0.101) overall. In the placebo group, BMD and TBS increased by ≤0.2% or decreased from baseline at each visit. In the denosumab group, progressive increases from baseline at 12, 24, and 36 months were observed for BMD (5.7, 7.8, and 9.8%) and TBS (1.4, 1.9, and 2.4%). Percentage changes in TBS were statistically significant compared with baseline (p < 0.001) and placebo (p ≤ 0.014). TBS was largely unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r 2 ≤ 0.06). Conclusions In postmenopausal women with osteoporosis, denosumab significantly improved TBS independently of BMD.

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Section: Discussionmentioning

confidence: 44%

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

McClung¹,

Lippuner²,

Brandi³

et al. 2017

Osteoporos Int

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“…Thereby, the increased bone density may not translate as effectively into increased bone stability as in situations where both BMD and TBS increase as in the treatment of postmenopausal osteoporosis (40).…”

Section: Discussionmentioning

confidence: 99%

Treatment of acromegaly increases BMD but reduces trabecular bone score: a longitudinal study

Godang

Olarescu

Bollerslev

et al. 2016

European Journal of Endocrinology

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Context: Bone turnover is increased in acromegaly. Despite normalization of bone turnover after treatment, the risk for vertebral fractures remains increased. Gonadal status, but not BMD, is correlated with vertebral fractures. Trabecular bone score (TBS) is related to bone microarchitecture. Objective: The aim of this study is to assess the longitudinal change in TBS and BMD following treatment for acromegaly. Results: Following treatment, the mean TBS decreased by 3.0 (±7.0) %, whereas the BMD at the lumbar spine (LS) increased by 3.2 (±4.9) % (both P < 0.01). The changes in BMD LS and TBS were not correlated (P = 0.87). The TBS change was found to be −4.5 % (±6.7; P = 0.003) in men and −0.3 % (±6.8; P = 0.85) in women (P = 0.063 for interaction men vs women). The mean BMD LS increased in men +4.2 g/cm 2 (±4.3; P < 0.001), but not in women +1.5 g/ cm 2 (±5.6; P = 0.36); (P = 0.073 for interaction). BMD increased in the ultradistal radius and total body (both P < 0.01).The increase in BMD LS was associated with a decrease in P1NP and CTX-1 (P < 0.001) and with lower P1NP and CTX-1 at the follow-up (P < 0.02). Conclusion: Treatment of acromegaly affects TBS and BMD at LS in different manners. The reduction of bone turnover markers predicts the increase in BMD but not the decrease in TBS. The DXA changes were more pronounced in men. Alterations in trabecular bone architecture may explain the persistent fracture risk despite the increase in BMD after disease control.

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“…Several relatively small studies have examined treatment-induced changes in TBS [49,50,53,[56][57][58][59] (Table 3). Of these, four were studies of osteoporosis treatment in postmenopausal women, one in both men and women with osteoporosis, and two in the management of breast cancer.…”

Section: Is Tbs Responsive To Treatment?mentioning

confidence: 99%

Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice

Harvey

Glüer

Binkley

et al. 2015

Bone

395

255

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Trabecular bone score (TBS) is a recently-developed analytical tool that performs novel grey-level texture measurements on lumbar spine dual X-ray absorptiometry (DXA) images, and thereby captures information relating to trabecular microarchitecture. In order for TBS to usefully add to bone mineral density (BMD) and clinical risk factors in osteoporosis risk stratification, it must be independently associated with fracture risk, readily obtainable, and ideally, present a risk which is amenable to osteoporosis treatment. This paper summarizes a review of the scientific literature performed by a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. Low TBS is consistently associated with an increase in both prevalent and incident fractures that is partly independent of both clinical risk factors and areal BMD (aBMD) at the lumbar spine and proximal femur. More recently, TBS has been shown to have predictive value for fracture independent of fracture probabilities using the FRAX ® algorithm. Although TBS changes with osteoporosis treatment, the magnitude is less than that of aBMD of the spine, and it is not clear how change in TBS relates to fracture risk reduction. TBS (corresponding author post-publication: nch@mrc.soton.ac.uk. (corresponding author pre-publication: w.j.pontefract@sheffield.ac.uk). Europe PMC Funders Group Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts may also have a role in the assessment of fracture risk in some causes of secondary osteoporosis (e.g. diabetes, hyperparathyroidism and glucocorticoid-induced osteoporosis). In conclusion, there is a role for TBS in fracture risk assessment in combination with both aBMD and FRAX.

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Comparative effects of teriparatide and ibandronate on spine bone mineral density (BMD) and microarchitecture (TBS) in postmenopausal women with osteoporosis: a 2-year open-label study

Cited by 80 publications

References 46 publications

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis

Treatment of acromegaly increases BMD but reduces trabecular bone score: a longitudinal study

Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice

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