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ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2026

Efficacy of romosozumab followed by denosumab in glucocorticoid users; a randomized clinical trial.

Mai Kawazoe, Shotaro Masuoka, Kaichi Kaneko, Zento Yamada, Karin Furukawa, Eri Watanabe, Keiko Koshiba, Soichi Yamada, Sei Muraoka, Hiroshi Sato and 5 more

Abstract read
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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Mai KawazoeDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.ORCID http://orcid.org/0000-0002-9822-8067
Shotaro MasuokaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Kaichi KanekoDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.ORCID http://orcid.org/0000-0002-2082-6948
Zento YamadaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Karin FurukawaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Eri WatanabeDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Keiko KoshibaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Soichi YamadaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Sei MuraokaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.ORCID http://orcid.org/0000-0002-9853-8057
Hiroshi SatoDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Izumi IritaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Miwa KanajiDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Takahiko SugiharaDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.ORCID http://orcid.org/0000-0002-7181-7494
Junko NishioDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
Toshihiro NankiDivision of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan. toshihiro.nanki@med.toho-u.ac.jp.ORCID http://orcid.org/0000-0002-3482-074X

Funding

JSPS KAKENHI JP 21K16665Project Research Grant from Toho University School of Medicine No.19-19
6 · The paper itself

Abstract

The efficacy of romosozumab (ROMO) in treating glucocorticoid-induced osteoporosis remains unclear. This randomized clinical trial demonstrated that in patients initiating glucocorticoid therapy, a treatment regimen of 12 months of ROMO followed by 24 months of denosumab (DMAb) was effective compared to either 36 months of DMAb or bisphosphonate monotherapy. PURPOSE: The efficacy of romosozumab (ROMO), an antibody against sclerostin-an inhibitor of Wnt signaling-in the treatment of glucocorticoid-induced osteoporosis remains uncertain, particularly regarding the sequential use of ROMO and denosumab (DMAb). This study aimed to compare the long-term efficacy of 12 months of ROMO followed by 24 months of DMAb (ROMO-DMAb) to 36 months of DMAb or bisphosphonates (BP) alone.

methodsPatients with rheumatic diseases who had not previously received osteoporosis drugs and were newly treated with prednisolone ≥ 15 mg/day were randomly assigned to receive ROMO (ROMO-DMAb group), DMAb, or risedronate. Over a 36-month period, we measured bone mineral density (BMD) at the lumbar spine, femoral neck, and total hip every 6 months.

resultsThirty-nine patients (median [interquartile ranges] age 72.0 [67.3 - 78.8] years; 69.2% women; prednisolone dose 20.0 [15.0 - 50.0] mg/day) were enrolled. The median percent change in lumbar spine BMD from baseline at 36 months was greatest in the ROMO-DMAb group (ROMO-DMAb; 11.3 [6.8 - 13.8] %, DMAb; 9.4 [4.7 - 13.5] %, BP; 2.1 [-1.3 - 6.8] %). The changes in the femoral neck and total hip were similar between the ROMO-DMAb and DMAb groups, and the increases were much smaller than that in the lumbar spine. Serum levels of total type I procollagen-N-propeptide and tartrate-resistant acid phosphatase-5b decreased in all groups from month 3.

conclusionSequential treatment with ROMO followed by DMAb increased lumbar spine BMD more than DMAb or BP alone up to 36 months, demonstrating the efficacy of this treatment strategy.

Indexed as

BisphosphonatesBone mineral densityDenosumabGlucocorticoid-induced osteoporosisRomosozumabWnt signaling

Identifiers

What OpenQuestion holds

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Registered trials

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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.