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Introduction <p>Despite the increasing number of anti-osteoporotic medications for improving bone mineral density (BMD) and reducing fracture risk, some patients show unsatisfactory responses.</p> Materials and methods <p>We retrospectively analyzed 2134 patients who received anti-osteoporotic medications between March 2020 and October 2024. BMD percentage changes at the lumbar spine, femoral neck, and total hip were assessed after 1&#xa0;year. Patients were categorized as “non-BMD gainers” (&lt;3% increase at all sites) or “BMD gainers” (≥3% increase at any site). Multivariable logistic regression was used to evaluate associations with non-BMD gainer status, including age, body mass index, baseline T-score, and medication class.</p> Results <p>578 patients (27.1%) were classified as non-BMD gainers. The observed rates of non-BMD gainer varied across medication classes in this real-world cohort, with selective estrogen receptor modulators (SERMs) showing the highest non-BMD gain rate (46.0%), followed by bisphosphonates (32.2%), teriparatide (35.1%), denosumab (19.5%), and romosozumab (5.6%). Non-BMD gainers had high baseline BMD and low bone turnover markers, and were more likely to have a history of osteoporosis treatment. In multivariable logistic regression analysis, older age (≥75&#xa0;years), SERM use, and high baseline BMD T-scores were independently associated with increased risk of non-BMD gainer status. Conversely, low T-scores (≤−3.0) were associated with a significantly reduced likelihood of being a non-BMD gainer.</p> Conclusion <p>Approximately 25% of patients did not achieve BMD gain after 1&#xa0;year of treatment. Older age, higher baseline BMD T-scores, and SERM use were associated with an increased probability of non-BMD gainer status in this observational study.</p>

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One-year bone mineral density gains with anti-osteoporotic medications and clinical factors associated with non-BMD gainers

  • 期刊论文

  • 发表日期：

    2025年10月3日

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  • Seol A Jang,
  • Seok-Jae Heo,
  • Su Jin Kwon,
  • Chul Sik Kim,
  • Seok Won Park,
  • Kyoung Min Kim

摘要

Introduction

Despite the increasing number of anti-osteoporotic medications for improving bone mineral density (BMD) and reducing fracture risk, some patients show unsatisfactory responses.

Materials and methods

We retrospectively analyzed 2134 patients who received anti-osteoporotic medications between March 2020 and October 2024. BMD percentage changes at the lumbar spine, femoral neck, and total hip were assessed after 1 year. Patients were categorized as “non-BMD gainers” (<3% increase at all sites) or “BMD gainers” (≥3% increase at any site). Multivariable logistic regression was used to evaluate associations with non-BMD gainer status, including age, body mass index, baseline T-score, and medication class.

Results

578 patients (27.1%) were classified as non-BMD gainers. The observed rates of non-BMD gainer varied across medication classes in this real-world cohort, with selective estrogen receptor modulators (SERMs) showing the highest non-BMD gain rate (46.0%), followed by bisphosphonates (32.2%), teriparatide (35.1%), denosumab (19.5%), and romosozumab (5.6%). Non-BMD gainers had high baseline BMD and low bone turnover markers, and were more likely to have a history of osteoporosis treatment. In multivariable logistic regression analysis, older age (≥75 years), SERM use, and high baseline BMD T-scores were independently associated with increased risk of non-BMD gainer status. Conversely, low T-scores (≤−3.0) were associated with a significantly reduced likelihood of being a non-BMD gainer.

Conclusion

Approximately 25% of patients did not achieve BMD gain after 1 year of treatment. Older age, higher baseline BMD T-scores, and SERM use were associated with an increased probability of non-BMD gainer status in this observational study.