{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T16:02:57Z","timestamp":1772726577030,"version":"3.50.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T00:00:00Z","timestamp":1706313600000},"content-version":"vor","delay-in-days":1152,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,2,12]],"date-time":"2023-02-12T00:00:00Z","timestamp":1676160000000},"content-version":"vor","delay-in-days":803,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015831","name":"Radius Health, Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015831","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015831","name":"Radius Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015831","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Although bone mineral density (BMD) is a predictor of fracture, many fractures occur in women with T-scores &amp;gt;\u2009\u22122.5. Bone microarchitecture, assessed by trabecular bone score (TBS), predicts fracture risk independent of BMD. We evaluated whether abaloparatide improves TBS and whether TBS trends were associated with vertebral fracture risk reduction. Women with osteoporosis randomized to abaloparatide or placebo for 18\u2009months (ACTIVE), followed by alendronate for 24\u2009months (ACTIVExtend), with evaluable TBS, were included in this post hoc analysis (N\u00a0=\u2009911). TBS was calculated from spine BMD scans using an algorithm adjusted for tissue thickness (TBSth) at baseline, 6, 18, and 43\u2009months. Mean increments in TBSth from baseline within and between treatment groups, proportion of women with TBSth increments above least significant change (LSC) and proportion with degraded TBSth (&amp;lt;1.027) were calculated. Risk estimates for vertebral fracture were compared using binary logistic regressions adjusted for baseline age and spine BMD. At baseline, 42% had degraded TBSth. Mean TBSth increased 4% after 18\u2009months abaloparatide (p\u00a0&amp;lt;\u20090.001) and was unchanged with placebo. After 2 subsequent years of alendronate, the total cumulative TBSth increase was 4.4% with abaloparatide\/alendronate and 1.7% with placebo\/alendronate (group difference, p\u00a0&amp;lt;\u20090.001). At 43\u2009months, the proportion of women with degraded TBSth had declined to 21% with abaloparatide\/alendronate and 37% with placebo\/alendronate (p\u2009&amp;lt;\u20090.05). An increase in TBSth\u00a0\u2265\u2009LSC was observed in 50% of abaloparatide-treated women at 18\u2009months and was associated with decreased odds (odds ratio [OR]; 95% confidence interval [CI]) of vertebral fracture (0.19; 95% CI, 0.04\u20130.80, 6\u2009months; 0.30; 95% CI, 0.11\u20130.79, 43\u2009months). In conclusion, abaloparatide increased TBSth rapidly and progressively over 18\u2009months and increments were maintained over 2\u2009years with alendronate. TBSth increase was associated with vertebral fracture risk reduction. Microarchitectural improvement may be one mechanism by which abaloparatide strengthens vertebral bone. \u00a9 2023 Radius Health, Inc and The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).<\/jats:p>\n                  <jats:p>Abstract<\/jats:p>\n                  <jats:p>Mean TBSth (95% CI) percent change over time. Both ABL and PBO ended at 18\u2009months (solid lines); at 19\u2009months, all subjects started ALN for 24\u2009months (dotted lines). *p\u00a0&amp;lt;\u20090.001. ABL, abaloparatide; ALN, alendronate; CI, confidence interval; PBO, placebo; TBSth, trabecular bone score adjusted for tissue thickness.<\/jats:p>","DOI":"10.1002\/jbmr.4764","type":"journal-article","created":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T23:29:25Z","timestamp":1672615765000},"page":"464-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Effect of Abaloparatide on Bone Microarchitecture Assessed by Trabecular Bone Score in Women With Osteoporosis: Post Hoc Analysis of ACTIVE and ACTIVExtend"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4554-6616","authenticated-orcid":false,"given":"Felicia MD","family":"Cosman","sequence":"first","affiliation":[{"name":"Columbia University New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier PhD","family":"Hans","sequence":"additional","affiliation":[{"name":"Interdisciplinary Center of Bone Diseases Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6338-2948","authenticated-orcid":false,"given":"Enisa PhD","family":"Shevroja","sequence":"additional","affiliation":[{"name":"Interdisciplinary Center of Bone Diseases Lausanne University Hospital and Lausanne University Lausanne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamei PhD","family":"Wang","sequence":"additional","affiliation":[{"name":"Radius Health, Inc. Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7050-0703","authenticated-orcid":false,"given":"Bruce MD","family":"Mitlak","sequence":"additional","affiliation":[{"name":"Radius Health, Inc. Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,1,1]]},"reference":[{"key":"2024012714095543900_jbmr4764-bib-0001","volume-title":"Bone Health and Osteoporosis: A Report of the Surgeon General","author":"Office of the Surgeon General (US)","year":"2004"},{"issue":"1","key":"2024012714095543900_jbmr4764-bib-0002","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1080\/21556660.2019.1677674","article-title":"Impact of fractures on quality of life in patients with osteoporosis: a US cross-sectional survey","volume":"8","author":"Gold","year":"2019","journal-title":"J Drug Assess"},{"issue":"7","key":"2024012714095543900_jbmr4764-bib-0003","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1177\/1060028020970518","article-title":"Economic burden of osteoporosis-related fractures in the US Medicare population","volume":"55","author":"Williams","year":"2021","journal-title":"Ann Pharmacother"},{"issue":"10","key":"2024012714095543900_jbmr4764-bib-0004","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00198-014-2794-2","article-title":"Clinician's guide to prevention and treatment of osteoporosis","volume":"25","author":"Cosman","year":"2014","journal-title":"Osteoporos Int"},{"issue":"1","key":"2024012714095543900_jbmr4764-bib-0005","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s11657-018-0430-z","article-title":"The burden and undertreatment of fragility fractures among senior women","volume":"13","author":"Rodrigues","year":"2018","journal-title":"Arch Osteoporos"},{"issue":"Suppl 1","key":"2024012714095543900_jbmr4764-bib-0006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/GL-2020-0524SUPPL","article-title":"American Association of Clinical Endocrinologists\/American College of Endocrinology Clinical Practice Guidelines for the diagnosis and treatment of postmenopausal Osteoporosis-2020 update","volume":"26","author":"Camacho","year":"2020","journal-title":"Endocr Pract"},{"key":"2024012714095543900_jbmr4764-bib-0007","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.bone.2015.05.016","article-title":"Trabecular bone score (TBS) as a new complementary approach for osteoporosis evaluation in clinical practice","volume":"78","author":"Harvey","year":"2015","journal-title":"Bone"},{"key":"2024012714095543900_jbmr4764-bib-0008","year":"2007"},{"issue":"3","key":"2024012714095543900_jbmr4764-bib-0009","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00198-012-2008-8","article-title":"Is bone microarchitecture status of the lumbar spine assessed by TBS related to femoral neck fracture? 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