Skip to main content
ACR Convergence 2025 Main banner
Final Program


Schedule at a Glance
Legend
Presentation Icons
CME
CME
Non-CME
Non-CME
In Person
In Person
On Demand
On Demand
Live Stream
Live Stream
Active Learning
Active Learning
Choose Rheum
Choose Rheum
Emerging Investigator Awardee
Emerging Investigator Awardee

Abstract Session

Metabolic Bone Disease

Session: Abstracts: Osteoporosis & Metabolic Bone Disease – Basic & Clinical Science (2591–2596)

2592: Romosozumab and Denosumab Combination Therapy in Postmenopausal Osteoporosis

Tuesday, October 28, 2025
1:15 PM - 1:30 PM Central Time
Location: W192A-C

    Presenting Author(s)

  • GA

    Giovanni Adami, MD

    University of Verona, Italy
    Verona, Verona, Italy

    Disclosure(s): No financial relationships with ineligible companies to disclose


Background/Purpose: Transition from long-term denosumab to PTH-analogs or romosozumab might expose patients to the risk of the so-called rebound phenomenon. Adding romosozumab to denosumab might represent an option in patients experiencing a fracture while on denosumab. The aim of this study was to investigate the effects of the combination of romosozumab to denosumab in post-menopausal osteoporosis.

Methods: We did a 36-month prospective, quasi-experimental, study. Post-menopausal women were divided into two groups: patients on denosumab who added romosozumab to denosumab (Dmab from M-24 to M0 à Dmab+Romo from M0 to M+12), and matched controls on denosumab continuing denosumab (Dmab from M-24 to M0 à Dmab from M0 to M+12). Patients for this group were selected from the overall pool of post-menopausal women treated with denosumab referring to our outpatient clinic who had available baseline (M-24) and follow-up DXA scans and serum samples collected (n=388). Patients were then matched through propensity score matching to balance baseline characteristics between the treated and control groups. Bone mineral density (BMD) and bone turnover markers (CTX, P1NP) were assessed at follow-up time points.

Results: A total of 50 women were included in the study. Twenty-five patients in the Dmab à Dmab+Romo group and 25 matched controls in the Dmab à Dmab group. Overall, lumbar spine BMD increased more in the Dmab à Dmab+Romo group (11.6% SE 3.0, p 0.010) compared to the Dmab à Dmab group (8.3% SE 3.3, p NS). Adding romosozumab to denosumab increased P1NP significantly between M0 and M+3 (+22.5 ng/mL SE 8.7, p 0.028). Figure 1 shows the bone markers trends in the two groups, Figure 2 shows the BMD trends in the two groups.

Conclusion: Ongoing treatment with denosumab did not blunt the anabolic response of romosozumab, indicating sustained modeling-based bone formation activity. Adding romosozumab in patients failing denosumab might be a valuable option.