The trabecular bone score (TBS) is arising as a new substitute for trabecular bone microarchitecture assessment. This technique is independent of BMD and is estimated from pixel grey-level variations in the lumbar spine (LS) dual-energy X-ray absorptiometry (DXA) image. TPTD has shown to increase LS-BMD and TBS in 2 years, but the exact timeline of these parameters was not known till date. The present study was conducted to assess the changes in LS-BMD and the TBS in osteoporotic patients treated with TPTD, followed by MINO.

The patients with primary osteoporosis with a low LS-BMD (T-score < -2.5) and/or with one minimum vertebral fracture were provided with TPTD 20 µg/day via subcutaneous route for 12-24 months, followed by MINO 50 mg once monthly via oral route for twelve months.

Measurement of LS-BMD and the TBS was done at 0, 3, 6, 12, and 24 months after the start of TPTD treatment, and 12 months after the start of MINO. The increments of LS-BMD notable at six months was found to increase till 12 months, whereas the increments of TBS, notable at three months were maintained till 12 months. Both BMD and the TBS were well maintained by TPTD treatment, followed by 12 months of MINO.