Comparative bone histomorphometry effects of combined denosumab and teriparatide vs monotherapy in postmenopausal women with osteoporosis: a randomized controlled trial.

Ramchand SK, Tsai JN, Zhao Y, Hershman SH, Tobert DG, Lee H, Martins JS, David NL, Sassana-Khadka G, Ryan S, Demay MB, Leder BZ

Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research1 Apr 2026Cited by 4 (Europe PMC)

PMID41128757PMCIDPMC13202730DOI10.1093/jbmr/zjaf152PepBankPUB-41128757

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Summary

The text of this summary is not shown here, because the article license does not allow reuse. Read it at the source (opens in a new tab)

Text rights: Publisher copyright. Results still quote short attributed sentences.

Results from this study8

3 results from studies that gave the peptide. 3 results from people.

01HumanRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased BFR/BS more than denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide increased bone formation rate per bone surface more than denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseBFR/BS versus denosumab
Study
n: not reported in source
Comparator
Denosumab
Outcome group
Bone and joint · Musculoskeletal
Studied dose
20 μg · 3 monthsAs given in this study (human).
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
Report a problemFND-4112875701
02HumanRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased MS/BS more than denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide increased mineralizing surface per bone surface more than denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseMS/BS versus denosumab
Study
n: not reported in source
Comparator
Denosumab
Outcome group
Bone and joint · Musculoskeletal
Studied dose
20 μg · 3 monthsAs given in this study (human).
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
Report a problemFND-4112875702
03HumanRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased dLS/BS more than denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide increased double-labeled surface per bone surface more than denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreasedLS/BS versus denosumab
Study
n: not reported in source
Comparator
Denosumab
Outcome group
Bone and joint · Musculoskeletal
Studied dose
20 μg · 3 monthsAs given in this study (human).
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
Report a problemFND-4112875703

Studies that did not test the peptide alone5

In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Teriparatide (PTH 1-34).

04HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased BFR/BS more than teriparatide plus denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide alone increased bone formation rate per bone surface more than teriparatide plus denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseBFR/BS versus combination
Study
n: not reported in source
Comparator
Teriparatide plus denosumab
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Report a problemFND-4112875704
05HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased MS/BS more than teriparatide plus denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide alone increased mineralizing surface per bone surface more than teriparatide plus denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseMS/BS versus combination
Study
n: not reported in source
Comparator
Teriparatide plus denosumab
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Report a problemFND-4112875705
06HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide increased dLS/BS more than teriparatide plus denosumab.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide alone increased double-labeled surface per bone surface more than teriparatide plus denosumab.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreasedLS/BS versus combination
Study
n: not reported in source
Comparator
Teriparatide plus denosumab
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
At 3 mo, teriparatide significantly increased histomorphometric indices of bone formation (BFR/BS, MS/BS, and dLS/BS) compared to denosumab or combination therapy, consistent with its greater effect on bone formation markers.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Report a problemFND-4112875706
07HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide plus denosumab increased remodeling-based bone formation.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide plus denosumab increased remodeling-based bone formation.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseRemodeling-based bone formation with combination
Study
n: not reported in source
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
Although both remodeling- and modeling-based bone formation increased in the combination group, denosumab attenuated the teriparatide-induced increases bone in formation, except for modeling-based bone formation in the endocortical envelope.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Report a problemFND-4112875707
08HumanNot a test of Teriparatide (PTH 1-34) aloneRandomized controlled trialEfficacy outcome
In postmenopausal women with osteoporosis, teriparatide plus denosumab increased modeling-based bone formation.
In plain wordsIn postmenopausal women with osteoporosis, teriparatide plus denosumab increased modeling-based bone formation.
Peptide
Teriparatide (PTH 1-34)
Outcome
IncreaseModeling-based bone formation with combination
Study
n: not reported in source
Outcome group
Bone and joint · Musculoskeletal
Source sentences
Summary
Although both remodeling- and modeling-based bone formation increased in the combination group, denosumab attenuated the teriparatide-induced increases bone in formation, except for modeling-based bone formation in the endocortical envelope.
2 context sentences(design, population, supporting numbers)
Summary · context
In this randomized, 3-arm interventional trial, postmenopausal women with osteoporosis were randomized to receive denosumab 60-mg (n = 9), teriparatide 20-μg (n = 13), or both (n = 12) for 3 mo.
Summary · context
A total of 26 bone biopsies were suitable for histomorphometry.
In this study, Teriparatide (PTH 1-34) was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Teriparatide (PTH 1-34).
Report a problemFND-4112875708

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
22 Oct 2026, 02:26 UTC
Study results updated
Version 1
21 Oct 2026, 18:59 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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