Comparison of the Efficacy of Romosozumab and Teriparatide for the Management of Osteoporotic Vertebral Compression Fractures

Abstract

Objective: Romosozumab is increasingly employed to manage osteoporosis. However, no studies have analyzed its effects on recent osteoporotic vertebral compression fractures (OV-CFs). Therefore, this study aimed to evaluate the efficacy of romosozumab compared with teriparatide in managing OVCFs. Methods: The electronic medical records of postmenopausal patients with recent OVCFs who were administered romosozumab or teriparatide for one year from March 2018 to Au-gust 2022 were retrospectively reviewed. We compared the 2 groups for demographics, ra-diological outcomes (compression ratio, Cobb angle, and bone mineral density [BMD]), and clinical outcomes (Numerical Rating Scale [NRS] for back pain). Results: Fifty-five patients with OVCFs, 32 patients treated with romosozumab and 23 with teriparatide, were included in this study. The change of BMD (g/cm2) values was significantly higher (p = 0. 016) in the romosozumab (0. 04 ± 0. 06) than in the teriparatide group (0. 00 ± 0. 08) in the femur total. Furthermore, in subgroup analysis, the change of BMD (g/cm2) values in the lumbar spine was significantly higher (p = 0. 016) in the romosozumab (0. 12 ± 0. 06) than in the teriparatide group (0. 07 ± 0. 06) in the lumbar spine. The decrease in NRS was significantly higher (p = 0. 013) in the romosozumab (6. 6 ± 2. 0) than in the terip-aratide group (5. 5 ± 2. 1). However, there was no significant difference in radiologic outcomes between the 2 groups. Conclusion: Our findings suggest that romosozumab may be more effective than teripara-tide in treating OVCFs in postmenopausal females, particularly in improving BMD and reducing back pain as measured by NRS. © 2023, Korean Spinal Neurosurgery Society. All rights reserved.