Table 1_Real-world treatment outcomes in pregnancy and lactation-associated osteoporosis: a nationwide multicenter cohort study.docx

Overall, 86.4% of patients had vertebral fractures, and 67.8% had multiple fractures. Of the 59 patients, 10 received bisphosphonates, 3 received denosumab, 22 received TPTD, and 24 received calcium/vitamin D supplementation alone as first-line treatment. Lumbar spine BMD improved significantly in all treatment groups and total hip BMD in the teriparatide and calcium/vitamin D groups, whereas femoral neck BMD improved significantly only in the teriparatide group.

Women receiving TPTD demonstrated greater early improvement in lumbar spine BMD than those managed with calcium/vitamin D alone (19.1% vs 9.5%; Hodges–Lehmann median difference, 11.5 percentage points [95% CI, 1.5 to 22.8]; P = 0.019). However, the between-group difference in lumbar spine BMD improvement was no longer significant at the second follow-up. After adjustment for baseline lumbar spine BMD, age, BMI and multiple vertebral fractures, treatment group was no longer independently associated with early lumbar spine BMD change (B = 3.0 percentage points, 95% CI −12.8 to 18.9; P = 0.698).</p>Conclusions<p>Women with PLO showed substantial recovery in bone density during follow-up across treatment groups.

Although women receiving TPTD demonstrated greater early lumbar spine BMD improvement in unadjusted analyses, this association was not independent after multivariable adjustment, and between-group differences were no longer observed during later follow-up. Prospective comparative studies are needed to define the optimal treatment strategy.</p>