According to the recent study published in The Japanese Society for Bone and Mineral Research journal, a significant increase in the lumbar spine, total hip and femoral neck bone mineral density (BMD) were observed after switching from bisphosphonates (BP) to denosumab (DMAb) or daily teriparatide (TPTD). Also, at 18 months, the trabecular bone score (TBS) was higher in the switch-to-TPTD group as compared to the BP-continue group.

 RA affects the joints of the hands, feet, wrists, elbows, knees, and ankles. About 1.5 million people in the United States have RA. In women, RA most generally occurs between ages 30 and 60. In the male, it often happens later in life. RA patients may experience a reduction in bone mineral density (BMD) with a significant increase in disease activity and risk of fractures.

This observational, non-randomized study aimed to clarify the unknown effects of switching oral BPs to DMAb or daily TPTD in subjects with RA. The characteristics of the 194 female patients involved in the evaluation were 183 postmenopausal, age 65.9 years, lumbar spine (LS) T score −1.8, femoral neck (FN) T score −2.3, dose and rate of administered oral prednisolone (3.6 mg/day) 75.8%, and prior BP therapy duration 40.0 months. The subjects were divided into

• the BP-continue group (n = 80)
• the switch-to-DMAb group (n = 74)
• the switch-to-TPTD group (n = 40)

The rise in bone mineral density (BMD) was consequently higher in the switch-to-DMAb group than in the BP-continue group (LS 5.2 vs 2.3%, FN 3.8 vs 0.0%) and in the switch-to-TPTD group than in the BP-continue group (LS 9.0 vs 2.3%, FN 4.9 vs 0.0%) after 18 months. Moreover, the switch-to-TPTD group noted trabecular bone score (TBS) (2.1 vs −0.7%;) rise and a greater LS BMD (P < 0.05) than the switch-to-DMAb group. Clinical fracture occurrence throughout the period was 8.8% in the BP-continue group, 4.1% in the switch-to-DMAb group, and 2.5% in the switch-to-TPTD group.