***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: BACKGROUND Sclerostin is an osteocyte-derived inhibitor of osteoblast activity . The monoclonal antibody romosozumab binds to sclerostin and increases bone formation . METHODS In a phase 2 , multicenter , international , r and omized , placebo-controlled , parallel-group , eight-group study , we evaluated the efficacy and safety of romosozumab over a 12-month period in 419 postmenopausal women , 55 to 85 years of age , who had low bone mineral density ( a T score of -2.0 or less at the lumbar spine , total hip , or femoral neck and -3.5 or more at each of the three sites ) . Participants were r and omly assigned to receive subcutaneous romosozumab monthly ( at a dose of 70 mg , 140 mg , or 210 mg ) or every 3 months ( 140 mg or 210 mg ) , subcutaneous placebo , or an open-label active comparator -- oral alendronate ( 70 mg weekly ) or subcutaneous teriparatide ( 20 μg daily ) . The primary end point was the percentage change from baseline in bone mineral density at the lumbar spine at 12 months . Secondary end points included percentage changes in bone mineral density at other sites and in markers of bone turnover . RESULTS All dose levels of romosozumab were associated with significant increases in bone mineral density at the lumbar spine , including an increase of 11.3 % with the 210-mg monthly dose , as compared with a decrease of 0.1 % with placebo and increases of 4.1 % with alendronate and 7.1 % with teriparatide . Romosozumab was also associated with large increases in bone mineral density at the total hip and femoral neck , as well as transitory increases in bone-formation markers and sustained decreases in a bone-resorption marker . Except for mild , generally nonrecurring injection-site reactions  with romosozumab  , adverse events were similar among groups . CONCLUSIONS In postmenopausal women with low bone mass  , romosozumab was associated with increased bone mineral density and bone formation and with decreased bone resorption . ( Funded by Amgen and UCB Pharma ; Clinical Trials.gov number , NCT00896532 . ) Summary The FREEDOM study and its Extension provide long-term information about the effects of denosumab for the treatment of postmenopausal osteoporosis . Treatment for up to 8 years was associated with persistent reduction of bone turnover , continued increases in bone mineral density , low fracture incidence , and a favorable benefit/risk profile . Introduction This study aims to report the results through year 5 of the FREEDOM Extension study , representing up to 8 years of continued denosumab treatment in postmenopausal women with osteoporosis . Methods Women who completed the 3-year FREEDOM study were eligible to enter the 7-year open-label  FREEDOM Extension in which all participants are scheduled to receive denosumab , since placebo assignment was discontinued for ethical reasons . A total of 4550 women enrolled in the Extension ( 2343 long-term ; 2207 cross-over ) . In this analysis , women in the long-term and cross-over groups received denosumab for up to 8 and 5 years , respectively . Results Throughout the Extension , sustained reduction of bone turnover markers ( BTMs ) was observed in both groups . In the long-term group , mean bone mineral density ( BMD ) continued to increase significantly at each time point measured , for cumulative 8-year gains of 18.4 and 8.3 % at the lumbar spine and total hip , respectively . In the cross-over group , mean BMD increased significantly from the Extension baseline for 5-year cumulative gains of 13.1 and 6.2 % at the lumbar spine and total hip , respectively . The yearly incidence of new vertebral and nonvertebral fractures remained low in both groups . The incidence of adverse and serious adverse events did not increase over time . Through Extension year 5 , eight events of osteonecrosis of the jaw and two events of atypical femoral fracture were confirmed . Conclusions Denosumab treatment for up to 8 years was associated with persistent reductions of BTMs , continued BMD gains , low fracture incidence , and a consistent safety profile Background A restriction in functional capacity occurs in all hip fractures and a variety of factors have been shown to influence patient functional outcome . This study sought to provide new and comprehensive insights into the role of factors influencing functional recovery six months after an accidental hip fracture . Methods A prospect i ve cohort study was conducted of patients aged 65 years or more who attended the Emergency Room ( ER ) for a hip fracture due to a fall .  The following were studied as independent factors : socio-demographic data ( age , sex , instruction level , living condition , received help ) , comorbidities , characteristics of the fracture , treatment performed , destination at discharge , health-related quality of life ( 12-Item Short Form Health Survey ) and hip function ( Short Western Ontario and McMaster Universities Osteoarthritis Index ) . As main outcome functional status was measured ( Barthel Index and Lawton Instrumental Activities of Daily Living Scale ) . Data were collected during the first week after fracture occurrence and after 6 months of follow-up . Patients were considered to have deteriorated if there was worsening in their functional status as measured by Barthel Index and Lawton IADL scores . Factors associated with the outcome were studied via logistic regression analysis . Results Six months after the fall , deterioration in function was notable , with mean reductions of 23.7 ( 25.2 ) and 1.6 ( 2.2 ) in the Barthel Index and Lawton IADL Scale scores respectively . Patients whose status deteriorated were older , had a higher degree of comorbidity and were less educated than those who remained stable or improved . The multivariate model assessing the simultaneous impact of various factors on the functional prognosis showed that older patients , living with a relative or receiving some kind of social support and those with limited hip function before the fall had the highest odds of having losses in function . Conclusion In our setting , the functional prognosis of patients is determined by clinical and social factors , already present before the occurrence of the fracture . This could make it necessary to perform comprehensive assessment s for patients with hip fractures in order to identify those with a poor functional prognosis to tackle their specific needs and improve their recovery Biochemical markers of bone turnover may be useful aids for managing patients with osteoporosis . A 12-month , phase 3 , multicenter trial of Japanese patients at high risk of fracture was conducted to assess the effects of teriparatide 20 μg/day on BMD , serum markers of bone turnover , and safety .  Two-hundred and seven subjects ( 93 % female ; median age 70 years ) were r and omized in double-blind fashion 2:1 to teriparatide versus placebo .  Bone turnover markers including procollagen type I N-terminal propeptide ( PINP ) , bone-specific alkaline phosphatase ( bone ALP ) and type I collagen cross-linked C-telopeptide ( CTX ) were collected at baseline , 1 , 3 , 6 , and 12 months . Lumbar spine , femoral neck , and total hip BMD were measured at baseline , 3 , 6 , and 12 months . Increases in PINP at 1 month correlated best with increases in lumbar spine BMD at 12 months ( r=0.76 ; P<0.01 ) . The proportions of patients with an increase from baseline in PINP > 10 μg/L at 1 , 3 , and 6 months were 3 % , 0 % , and 2 % in the placebo , and 93 % , 87 % , and 83 % in the teriparatide group . The proportions of patients with an increase in PINP > 10 μg/L at either 1 or 3 months were 3 % in the placebo and 95 % in the teriparatide group ( P<0.001 ) . The proportions of patients with a significant increase in lumbar spine BMD ( increase from baseline ≥3 % ) at 12 months were 20 % in the placebo and 94 % in the teriparatide group . The proportions of patients with an increase in PINP > 10 μg/L at 1 or 3 months and an increase in lumbar spine BMD ≥3 % at 12 months was 0 % of placebo group patients and 92 % of teriparatide group patients ( P<0.001 ) . These data confirm a strong relationship between early change in PINP and later change in lumbar spine BMD  during teriparatide therapy . Also , these results suggest that monitoring with PINP and lumbar spine BMD successfully identifies positive responses in most patients taking teriparatide and negative responses in most patients not taking teriparatide . PINP monitoring may be a useful aid in the management of patients with osteoporosis during teriparatide treatment BACKGROUND Romosozumab is a monoclonal antibody that inhibits sclerostin and rapidly increases bone mineral density ( BMD ) through a dual effect on bone by increasing bone formation and decreasing bone resorption , as shown in a global phase 2 study in postmenopausal women with low bone mass . Here , we report the key results of a phase 2 , double-blind , placebo-controlled , dose-ranging study to assess the efficacy and safety of romosozumab in postmenopausal Japanese women with osteoporosis . METHODS Participants were postmenopausal Japanese women with osteoporosis aged 55 - 85years with a lumbar spine , total hip , or femoral neck dual-energy X-ray absorptiometry T-score≤-2.5 . Women were r and omized to receive placebo or romosozumab ( 70 , 140 , or 210 mg ) subcutaneously once monthly ( QM ) for 12months . The primary efficacy endpoint was the percentage change from baseline in lumbar spine BMD at month 12 . Secondary efficacy endpoints included the percentage change from baseline in lumbar spine BMD at month 6 , total hip and femoral neck BMD at months 6 and 12 , and serum bone turnover markers procollagen type 1N-terminal propeptide ( P1NP ) and C-terminal telopeptide of type 1 collagen ( CTX ) at multiple visits . RESULTS This study enrolled 252 women who had a mean age of 67.7years and mean T-scores of -2.7 , -1.9 , and -2.3 at the lumbar spine , total hip , and femoral neck , respectively .  All romosozumab doses significantly increased BMD at month 12 compared with placebo ( p<0.01 ) , with the largest mean gains from baseline observed with romosozumab 210 mg QM ( lumbar spine=16.9 % , total hip=4.7 % , and femoral neck=3.8 % ) . All doses of romosozumab significantly increased the levels of bone-formation marker P1NP and reduced the levels of bone-resorption marker CTX by week 1 ( p<0.001 vs placebo ) . In the 210 mg QM group , P1NP levels peaked at month 1 and fell below placebo levels by month 12 ; CTX levels were lowest at week 1 and remained below placebo through month 12 . The patient incidences of adverse events and serious adverse events were generally comparable between treatment groups . CONCLUSIONS In postmenopausal Japanese women with osteoporosis , romosozumab treatment result ed in large and significant gains in BMD from baseline and compared with placebo . Romosozumab 210 mg QM showed the largest gains in BMD and was generally well tolerated . The efficacy and safety of romosozumab 210 mg QM in this phase 2 study of postmenopausal women with osteoporosis were similar to those in an international phase 2 study PURPOSE To compare the power of FRAX ® without bone mineral density ( BMD ) and simpler screening tools ( OST , ORAI , OSIRIS , SCORE and age alone ) in predicting fractures . METHODS This study was a prospect i ve , population -based study performed in Denmark comprising 3614 women aged 40 - 90 years , who returned a question naire concerning items on risk factors for osteoporosis .  Fracture risk was calculated using the different screening tools ( FRAX ® , OST , ORAI , OSIRIS and SCORE ) for each woman . The women were followed using the Danish National Register registering new major osteoporotic fractures during 3 years , counting only the first fracture per person . Area under the receiver operating characteristic curve ( ROC ) and statistics and Harrell 's index were calculated . Agreement between the tools was calculated by kappa statistics . RESULTS A total of 4 % of the women experienced a new major osteoporotic fracture during the follow-up period . There were no differences in the area under the curve ( AUC ) values between FRAX ® and the simpler tools ; AUC values between 0.703 and 0.722 ( p = 0.86 ) . Also , Harrell 's C values were very similar between the tools . Agreement between the tools was modest . CONCLUSION During 3 years follow-up FRAX ® did not perform better in the fracture risk prediction compared with simpler tools such as OST , ORAI , OSIRIS , SCORE or age alone in a screening scenario where BMD was not measured . These findings suggest that simpler models based on fewer risk 
    Output:
    
However , this difference was not statistically significant .
Treatment with anti-sclerostin antibodies can be a proper therapeutic option in patients with osteoporosis and low bone mineral density .
Based on the results of this meta- analysis , it seems that Romosozumab , with its dual function , has a positive role in the treatment of osteoporosis and low bone mineral density