ReviewArchives of endocrinology and metabolism2022
The why and how of sequential and combination therapy in osteoporosis. A review of the current evidence.
Review in Archives of endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06938152 (Effects of Cycle Therapy With Romosozumab and Denosumab 2 Years vs 1 Year Romosozumab Followed by 1 Year Denosumab in Postmenopausal Osteoporosis Patients-A Randomized Control Trial), which is not on this map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Cycle Therapy With Romosozumab and Denosumab 2 Years vs 1 Year Romosozumab Followed by 1 Year Denosumab in Postmenopausal Osteoporosis Patients-A Randomized Control Trial
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Pooled it
- Revisiting the activate depress free and repeat (ADFR) paradigm: Clinical use of cyclic romosozumab.Archives of osteoporosis · 2026Article
- Antiresorptive Use and Risk of Hip Fracture in Older Women with Osteoporosis: Findings from a Real-World National Database of 21,332 Women.Journal of clinical medicine · 2026Article
- Strontium Treatment Potentiates Bone Anabolic Action of Intermittent PTH in Ovariectomized Rats.Calcified tissue international · 2026Article
- Pre-teriparatide anti-osteoporosis medication therapy and fracture-related hospitalization in patients at very high fracture risk.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Osteoporosis and fragility fracture burden in Asia Pacific: Key findings from the APCO-IOF Asia Pacific Regional Audit.Osteoporosis and sarcopenia · 2026Review
- Sequential Versus Step-Therapy Approaches for Osteoporosis Management in Orthopedic Subspecialties.Current osteoporosis reports · 2026Review
- Phyto-chemistry and Therapeutic Potential of Natural Flavonoid Naringin: A Consolidated Review.Chinese journal of integrative medicine · 2026Review
- Longitudinal osteoporosis therapy: treat-to-target and sequential strategies-a narrative review.Therapeutic advances in musculoskeletal disease · 2026Review
- Parathyroid hormone receptor agonists in the management of osteoporosis.Nature reviews. Rheumatology · 2025Review
- Factors Associated With Compliance and Persistence With Pharmacotherapy in Patients With Osteoporosis: A Nationwide Cohort Study in Korea.Journal of Korean medical science · 2025Article
- A comprehensive review and advanced biomolecule-based therapies for osteoporosis.Journal of advanced research · 2025Review
- Review
- Asia-Pacific consensus on long-term and sequential therapy for osteoporosis.Osteoporosis and sarcopenia · 2024Review
- Insights and implications of sexual dimorphism in osteoporosis.Bone research · 2024Review
- The Development of Naringin for Use against Bone and Cartilage Disorders.Molecules (Basel, Switzerland) · 2023Review
- Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?Frontiers in physiology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It is now well recognized that over the lifetime of a patient with osteoporosis, more than one medication will be needed to treat the disease and to decrease fracture risk. Though current gaps in osteoporosis therapy can be potentially mitigated with sequential and combination regimens, how to move seamlessly amongst the multiple treatments currently available for osteoporosis for sustained efficacy is still unclear. Data from recent studies show that an anabolic agent such as teriparatide or romosozumab followed by an antiresorptive affords maximal gain in BMD and possibly better and earlier fracture risk reduction compared to a regimen which follows the opposite sequence. Sequentially moving to a bisphosphonate such as alendronate from an anabolic agent such as abaloparatide has also been shown to preserve the fracture reduction benefits seen with the latter. This sequence of an anabolic agent followed by an antiresorptive should especially be considered in the high-risk patient with imminent fracture risk to rapidly reduce the risk of subsequent fractures. The data surrounding optimum timing of initiation of bisphosphonate therapy following denosumab discontinuation is still unclear. Though data suggests that combining a bisphosphonate with teriparatide does not provide substantial BMD gains compared to monotherapy, the concomitant administration of denosumab with teriparatide has been shown to significantly increase areal BMD as well as to increase volumetric BMD and estimated bone strength. This narrative review explores the available evidence regarding the various sequential and combination therapy approaches and the potential role they could play in better managing osteoporosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.