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TBS
as a measure of bone quality may play a role in managing patients with
osteoporosis as denosumab considerably increased TBS independent of BMD in postmenopausal women with osteoporosis.
Trabecular bone
score (TBS) helps to evaluate the bone quality in the lumbar spine using
dual-energy X-ray absorptiometry (DXA) scans. The FREEDOM study by McClung MR
et al., showed that Denosumab increased BMD and reduced new vertebral fractures
in postmenopausal women with osteoporosis.
TBS, a
grey-level texture index determined from lumbar spine DXA scans, correlates
with bone microarchitecture and enhances the assessment of vertebral fracture
risk independently of BMD. This retrospective analysis assessed the effect of
denosumab on TBS and further the association of TBS to BMD.
The study
included postmenopausal women with lumbar spine or total hip BMD T-score
<-2.5 and -4.0 or higher at both sites were involved. They were provided
with placebo or Denosumab 60 mg subcutaneously every 6 months. In the study
population of 285 women (128 placebo, 157 Denosumab) who had TBS values at
baseline and ≥1 postbaseline visit, TBS indices were determined from DXA scans
at baseline and then at 12, 24, and 36 months.
The baseline characteristics were comparable between treatment groups. The mean (SD) lumbar spine BMD T-score was -2.79 (0.64) and mean TBS was 1.200). In placebo group from baseline at each visit, the BMD and TBS increased by ≤0.2%. In the Denosumab group, progressive increases from baseline at 12, 24, and 36 months were 5.7, 7.8, and 9.8% for BMD and 1.4, 1.9, and 2.4% for TBS. Percentage changes in TBS were statistically significant compared with baseline (p<0.001) and placebo (p≤0.014). It was observed that TBS was extensively unrelated to BMD, regardless of treatment, either at baseline or for annual changes from baseline (all r2≤0.06).
Overall, it can
be concluded that in postmenopausal women with
osteoporosis, Denosumab significantly improved TBS independently of BMD.
Osteoporos Int. 2017 Jul 26
Effect of denosumab on trabecular bone score in postmenopausal women with osteoporosis.
McClung MR et. al.
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