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Combining drug therapies that stimulate bone formation with those that inhibit resorption has theoretical appeal. The NIH-funded DATA trial (with manufacturer-provided study drugs) demonstrated that teriparatide plus denosumab resulted in greater, faster increases in bone mineral density (BMD) than either drug alone. In an extension of this trial, 77 participants who received teriparatide or denosumab for 2 years were switched to the other drug for 2 more years, while those who received both drugs continued on denosumab alone.
Continuing denosumab after combined therapy resulted in progressive increments in BMD (spine, 3.4%; total hip, 2.2%). BMD also increased in women who switched from teriparatide to denosumab. At 4 years, BMD in both gro…