E-Poster Presentation ESA-SRB-ANZBMS 2021

Probability of achieving T-scores goals above -2.5 with alendronate (ALN) or romosozumab (ROMO) followed by alendronate or denosumab (DMAB) (#745)

Jeffrey Hassall 1 , Steven Cummings 2 , Cesar Libanati 3 , Celeste Hamilton 4 , Zhigang Yu 4 , Wenjing Yang 4 , Serge Ferrari 5 , Jens-Erik Beck Jensen 6 , Pilar Peris Bernal 7 , Francesco Bertoldo 8 , Eric Lespessailles 9 , Eric Hesse 10 , Felicia Cosman 11
  1. Amgen Australia, Sydney, NSW, Australia
  2. San Francisco Coordinating Center, San Francisco, CA, USA
  3. UCB, Brusseles, Belgium
  4. Amgen Inc, Thousand Oaks, CA, USA
  5. Geneva University Hospital, Geneva, Switzerland
  6. Copenhagen University Hospital, Hvidovre, Denmark
  7. University of Barcelona, Barcelona, Spain
  8. University of Verona, Verona, Italy
  9. Centre Hospitalier Régional d'Orléans, Orléans, France
  10. Ludwig-Maximilians-University, Munich, Germany
  11. Columbia University, New York, NY, USA

Background: Increases in bone mineral density (BMD) reduce fracture risk in patients receiving treatment for osteoporosis. Goal-directed Treatment (also called ‘Treat-to-Target’) recommends that selection of initial treatment (anti-resorptive agent or bone-forming agent) for patients with a T-score <−2.5 should be based on the probability of achieving a goal BMD T-score ≥−2.5.

 

Objective: To compare the probability of achieving a T-score of ≥−2.5 at the total hip or lumbar spine after 3 years treatment with ALN only; or the treatment sequence of 12 months ROMO, followed by 2 years ALN (ROMO/ALN) or DMAB (ROMO/DMAB).

 

Methods: Female participants in the ARCH trial received ALN for 3 years or ROMO for 1 year followed by ALN for 2 years. Those in the FRAME trial received ROMO for 1 year followed by DMAB for 2 years. For participants with initial BMD T-scores <–2.5 at total hip or spine, we calculated the probability of achieving a T-score ≥–2.5 with the three treatments.

 

Results: The probabilities of achieving a T-score ≥–2.5 depended on baseline T-score and treatment; see Figure 1 for details.

 

Conclusion: Women with a baseline T-score ≥–3.0 at the spine or ≥–2.7 at the hip have at least a 50% chance to achieve a T-score ≥–2.5 with any of the three regimens. In contrast, those with a T-score below –3.0 at the spine, or –2.7 to –3.5 at the total hip, have a substantially greater probability of achieving T-scores ≥–2.5 when using a bone-forming agent first (i.e. ROMO/ALN or ROMO/DMAB vs. ALN alone). Those with hip T-scores ≤–3.5 may require more than 3 years of treatment that continues to improve BMD. These probabilities should be considered when selecting initial treatment.

 

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