Baseline serum PINP level is associated with the increase in hip bone mineral density seen with Romosozumab treatment in previously untreated women with osteoporosis

This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s00198-022-06642-1

Kashii M., Kamatani T., Nagayama Y., et al. Baseline serum PINP level is associated with the increase in hip bone mineral density seen with Romosozumab treatment in previously untreated women with osteoporosis. Osteoporosis International 34, 563 (2023)

Summary: Baseline serum PINP value was significantly and independently associated with theincreased bone mineral density (≥ 3%) in both total hip and femoral necks by 12months of romosozumab treatment in patients with treatment-naive postmenopausal osteoporosis. Purpose: Some patients fail to obtain a sufficiently increased hip bone mineral density (BMD) by romosozumab (ROMO) treatment. This study aimed to investigate the prognostic factor for increased hip BMD with ROMO in patients with treatment-naive postmenopausal osteoporosis. Methods: This prospective, observational, and multicenter study included patients (n = 63: mean age, 72.6years; T-scores of the lumbar spine [LS], − 3.3; total hip [TH], − 2.6; femoral neck [FN], − 3.3; serum type I procollagen N-terminal propeptide [PINP], 68.5µg/L) treated by ROMO for 12months. BMD and serum bone turnover markers were evaluated at each time point. A responder analysis was performed to assess the patient percentage, and both univariate and multivariate analyses were performed to investigate the factors associated with clinically significant increased BMD (≥ 3%) in both TH and FN. Results: Percentage changes of BMD from baseline in the LS, TH, and FN areas were 17.5%, 4.9%, and 4.3%, respectively. In LS, 96.8% of patients achieved ≥ 6% increased LS-BMD, although 57.1% could not achieve ≥ 3% increased BMD in either TH or FN. Multiple regression analysis revealed that only the baseline PINP value was significantly and independently associated with ≥ 3% increased BMD in both TH and FN (p = 0.019, 95% confidence interval = 1.006–1.054). The optimal cut-off PINP value was 53.7µg/L with 54.3% sensitivity and 92.3% specificity (area under the curve = 0.752). Conclusions: In a real-world setting, baseline PINP value was associated with theincreased BMD of TH and FN by ROMOtreatment in treatment-naive patients.