Comparison between different bone treatments on areal bone mineral density (aBMD) and bone microarchitectural texture as assessed by the trabecular bone score (TBS)

Purpose: The objective of the study was to assess longitudinal effects of different osteoporosis treatments on TBS and aBMD at lumbar spine. Method: We analyzed 390 patients (men: 72; women: 318; age >40 years; mean follow-up of 20 months and BMI <37 kg/m(2)). We stratified the cohort by treatments: Naive of treatment (Naive, n = 67), Calcium and Vitamin D (CaVitD, n = 87), Testosterone (Te, n = 36), Alendronate (AL, n = 88), Risedronate (Ri, n = 39), Denosumab (Dmb, n = 43) and Teriparatide (PTH, n = 30). The follow-up changes from baseline were normalized at 24 months. Results: After 24 months, Naive group TBS decreased by 3.1% (p < 0.05) whereas a non-significant increase was observed for spine aBMD (Delta = + 0.5%). Compared to the Naive group, significant improvement (p < 0.05) was observed in both TBS and aBMD for Te, AL, Ri, Dmb and PTH groups and in the CaVitD group for TBS. At the end of the follow-up, significant improvement have been observed for aBMD in Te (+ 4.4%), AL (+4.1%), Ri (+4.8), D (+8.8%) and PTH (+8.8%) groups. Significant improvement was observed only in the AL (+1.4%), Dmb (+2.8%) and PTH (+3.6%) groups for TBS. Conclusion: As expected, TBS of Naive subjects decreased with age. As expected a TBS preservation has been observed under AL and Ri.Te and CaVitD effects on TBS were evaluated for the first time: a similar preservation effect has been observed. A significant TBS increase was observed under Denosumab and PTH.TBS could be a useful tool to monitor treatment effects. (C) 2015 Elsevier Inc. All rights reserved.