Search

The Active‐Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) trial (NCT01631214; https://clinicaltrials.gov/ct2/show/NCT01631214) showed that romosozumab for 1 year followed by alendronate led to larger areal bone mineral density (aBMD) gains and superior fracture risk reduction versus alendronate alone. aBMD correlates with bone strength but does not capture all determinants of bone strength that might be differentially affected by various osteoporosis therapeutic agents. We therefore used quantitative computed tomography (QCT) and finite element analysis (FEA) to assess changes in lumbar spine volumetric bone mineral density (vBMD), bone volume, bone mineral content (BMC), and bone strength with romosozumab versus alendronate in a subset of ARCH patients. In ARCH, 4093 postmenopausal women with severe osteoporosis received monthly romosozumab 210 mg sc or weekly oral alendronate 70 mg for 12 months, followed by open‐label weekly oral alendronate 70 mg for ≥12 months. Of these, 90 (49 romosozumab, 41 alendronate) enrolled in the QCT/FEA imaging substudy. QCT scans at baseline and at months 6, 12, and 24 were assessed to determine changes in integral (total), cortical, and trabecular lumbar spine vBMD and corresponding bone strength by FEA. Additional outcomes assessed include changes in aBMD, bone volume, and BMC. Romosozumab caused greater gains in lumbar spine integral, cortical, and trabecular vBMD and BMC than alendronate at months 6 and 12, with the greater gains maintained upon transition to alendronate through month 24. These improvements were accompanied by significantly greater increases in FEA bone strength (p < 0.001 at all time points). Most newly formed bone was accrued in the cortical compartment, with romosozumab showing larger absolute BMC gains than alendronate (p < 0.001 at all time points). In conclusion, romosozumab significantly improved bone mass and bone strength parameters at the lumbar spine compared with alendronate. These results are consistent with greater vertebral fracture risk reduction observed with romosozumab versus alendronate in ARCH and provide insights into structural determinants of this differential treatment effect. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the relationship between habitual physical activity (HPA) during life and bone mineral density (BMD) in men aged 50 years and older.Methods: A total of 326 men aged 50 years and older, volunteers living in São Paulo city, Brazil, were studied. BMD was measured in the whole body, femoral neck, Ward's triangle, trochanter, and lumbar spine (L2-L4) with a dual-energy x-ray absorptiometer. The HPA data were collected with questionnaires inquiring about physical exercise and occupational physical activity in the past and during the past 12 months and leisure and locomotor physical activity in the preceding 12 months. The relationship between BMD and HPA was analyzed using multiple linear regression models adjusted for age and body mass index (BMI).Results: Practice of physical exercise in the past 10-20 years and leisure and locomotor physical activity in the preceding 12 months showed a significant positive correlation with BMD of whole body, femoral neck, trochanter, and lumbar spine, and this association was independent of age and BMI.Conclusions: HPA can contribute to preserving BMD in men aged 50 years and older in Brazil, when it is practiced in the past 10-20 years and even in the present. [ABSTRACT FROM AUTHOR]