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At Saitama-Sekishinkai Hospital, informed consent was obtained through an opt-out process, as the study was based on routinely collected clinical data. At the collaborating institution, written informed consent was obtained from all participants.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"At Saitama-Sekishinkai Hospital, the study was conducted using an opt-out approach, and study-related information was posted on the hospital\u2019s website to allow patients to decline participation. At the collaborating institution, written informed consent was obtained from all participants. In routine clinical practice, written informed consent was obtained for romosozumab and denosumab therapy. In the early phase of romosozumab use, when written consent forms were not yet routinely available, treatment was initiated based on oral informed consent.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"NI has received speaker honoraria from Amgen Inc. and Astellas Pharma Inc. for lectures on romosozumab, from Ono Pharmaceutical Co., Ltd. for lectures on etelcalcetide, and from Sanwa Kagaku Kenkyusho Co., Ltd. for lectures on upacicalcet in CKD-MBD management. These honoraria were received outside the submitted work. RK, KK, and YN declare that they have no conflict of interest.","order":3,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}