ArticleArchives of osteoporosis2026
TSH suppression attenuates the early efficacy of zoledronic acid in osteoporosis.
Article in Archives of osteoporosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
TSH suppression was associated with an attenuated early skeletal response to zoledronic acid in postoperative DTC patients with osteoporosis.
objectiveThis prospective study aimed to evaluate the impact of TSH suppression therapy on the early skeletal efficacy of zoledronic acid in patients with differentiated thyroid cancer (DTC), and to explore whether this response differs across subgroups.
methodsPatients were divided into two groups: the osteoporosis with TSH suppression group (TSH + OP, n = 42) and the osteoporosis without TSH suppression group (TSH - OP, n = 67). Both groups received a single infusion of zoledronic acid (5 mg) along with daily calcium and calcitriol supplementation. Primary analyses compared changes in bone mineral density (BMD) and bone turnover markers(BTMs) at 6 and 9 months post-treatment. After propensity score matching (PSM), 36 patients from each group were included in the primary analyses. Exploratory subgroup analyses were conducted according to age and sex.
resultsAfter PSM, the TSH + OP group showed significantly less BMD improvement compared to the TSH - OP group. At 9 months, the intergroup differences in BMD change were -7.08 mg/cm
conclusionTSH suppression therapy was associated with an attenuated early skeletal response to zoledronic acid in postoperative DTC patients with osteoporosis, with this attenuation being more pronounced at the hip and femoral neck. Exploratory subgroup analyses suggested that this attenuation was primarily observed in postmenopausal women. In patients undergoing TSH suppression, serum PINP and β-CTX are useful monitoring biomarkers.
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