Denosumab improves trabecular bone score in relationship with decrease in fracture risk of women exposed to aromatase...

Area of Science:

• Osteoporosis Research
• Medical Imaging Analysis
• Pharmacological Interventions

Background:

• Trabecular bone score (TBS) is a validated metric for assessing bone structure and fracture risk.
• Aromatase inhibitors (AIs) used in breast cancer treatment can induce bone loss and increase fracture risk.
• The impact of bone-modifying agents on TBS in AI-induced osteoporosis is not well-established.

Purpose of the Study:

• To evaluate the effects of denosumab and bisphosphonates (BPs) on TBS and vertebral fractures (VFs) in women with AI-induced osteoporosis.
• To determine if TBS changes can predict fracture risk in this patient population.

Main Methods:

• Retrospective analysis of 241 women with early breast cancer on AI therapy.
• Assessment of TBS, bone mineral density (BMD), and VFs at baseline and after 18-24 months.
• Comparison between groups receiving denosumab, BPs, or no bone-active treatment.

Main Results:

• Denosumab significantly increased TBS and reduced VF risk (P < 0.001 and P = 0.021, respectively).
• Bisphosphonates did not significantly alter TBS or VF incidence compared to untreated women.
• Decreased TBS was associated with incident VFs, independent of BMD changes.

Conclusions:

• TBS variation is a predictor of fracture risk in women treated with AIs.
• Denosumab demonstrates efficacy in improving TBS and lowering VF risk early in AI therapy.