Response to the Letter to the Editor on "Interpreting romosozumab-associated BMD changes in osteogenesis imperfecta:...

We respond to methodological questions raised in a "Letter to the Editor" regarding our retrospective case series on romosozumab treatment in osteogenesis imperfecta (OI). We clarify that the retrospective study design, the rarity of the disease, the small number of cases, and the exploratory nature of the analyses limit the methodological approaches as already acknowledged in our original manuscript. Thus, the primary concern is an inherent limitation of an exploratory study in a rare disease. Nevertheless, these data are helpful, as they generate new hypotheses given the currently very limited clinical data available.