Differing effects of denosumab and alendronate on cortical and trabecular bone

Abstract

Vertebral fractures and trabecular bone loss are hallmarks of osteoporosis. However, 80% of fractures are non-vertebral and 70% of all bone loss is cortical and is produced by intracortical remodeling. The resulting cortical porosity increases bone fragility exponentially. Denosumab, a fully human anti-RANKL antibody, reduces the rate of bone remodeling more than alendronate. The aim of this study was to quantify the effects of denosumab and alendronate on cortical and trabecular bone. Postmenopausal women, mean age 61. years (range 50 to 70), were randomized double blind to placebo (n=82), alendronate 70. mg weekly (n=82), or denosumab 60. mg every 6. months (n=83) for 12. months. Porosity ..