#4-11E. Tailoring Treatments for GIOP: Comparing Denosumab, Teriparatide, and Romosozumab (Rheumatology, 2026)

Are you struggling to choose the optimal bone-targeted therapy for patients with glucocorticoid-induced osteoporosis (GIOP)? In this episode, we explore a multicenter retrospective cohort study that compared the effectiveness of denosumab, teriparatide, and romosozumab using propensity score matching in GIOP patients over a 12-month period. The study revealed that while romosozumab and teriparatide were superior in increasing trabecular-rich lumbar spine bone mineral density (BMD), denosumab provided earlier benefits in preserving cortical bone at the total hip and femoral neck within the first 6 months. Critically evaluating this paper, listeners must remain mindful of its non-randomized observational design, which leaves room for inherent prescription selection bias, as anabolic agents like teriparatide and romosozumab are typically reserved for patients with higher baseline fracture risks in real-world settings. Despite this limitation, these findings are highly relevant to your daily clinical practice because they underscore the necessity of a site-specific, individualized treatment strategy; by understanding the distinct BMD responses at different skeletal sites, physicians can more precisely tailor osteoporosis therapies to match each patient's specific deficits.

Citation: Yukishima T, Ebina K, et al. Effectiveness of denosumab, teriparatide and romosozumab for glucocorticoid-induced osteoporosis: a propensity score-matched cohort study. Rheumatology. 2026. DOI: 10.1093/rheumatology/keag082

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.