While romosozumab was more effective than placebo at reducing the incidence of vertebral fractures in postmenopausal women with low bone mineral density, the difference in non-vertebral fractures did not reach statistical significance. 1 For women who have had a fracture, romosozumab appears to have an advantage over alendronate for preventing future fractures. 2 Whether the greater improvement in bone density, compared to teriparatide, in women switching from bisphosphonates results in fewer fractures remains to be seen. 3 As denosumab is often used when bisphosphonates are unsuitable, a comparative trial between denosumab and romosozumab would have been useful.
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