Objectives: The effectiveness of combining romosozumab (ROMO) with denosumab (Dmab) remains uncertain.We compare the six-month effects of Dmab plus monthly ROMO versus Dmab plus daily teriparatide (TPTD) on bone mineral density (BMD) in treatment-naïve postmenopausal women with osteoporosis. Methods: This retrospective cohort study analyzed 26 treatment-naïve postmenopausal women with primary osteoporosis. Participants received either a monthly regimen of ROMO and Dmab (N = 14) or a daily regimen of TPTD plus Dmab (N = 12). BMD at the lumbar spine, total hip, and femoral neck was measured at baseline, 3 months, and 6 months by dual-energy X-ray absorptiometry. Serum levels of C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP) were assessed at the same intervals. Results: Both regimens significantly improved lumbar spine BMD at 6 months (ROMO + Dmab: +9.75%; TPTD +Dmab: +7.42%). Improvements in total hip and femoral neck BMD were modest and similar between groups (~2%). Serum CTX and P1NP were significantly suppressed in both groups at 3 months, but P1NP suppression waned in the TPTD + Dmab group by 6 months. No statistically significant differences in BMD or marker changes were detected between the two regimens. Conclusions Both combination therapies effectively improve lumbar spine BMD over 6 months. The ROMO +Dmab regimen yielded numerically greater increases with fewer injections.

Background/Aims: Finite nucleos(t)ide analog (NA) therapy has been proposed as an alternative treatment strategy for chronic hepatitis B (CHB), but biomarkers for post-treatment monitoring are limited. We investigated whether measuring hepatitis B core-related antigen (HBcrAg) after NA cessation may stratify the risk of subsequent clinical relapse (CR). Methods: This retrospective multicenter analysis enrolled adults with CHB who were prospectively monitored after discontinuing entecavir or tenofovir with negative HBeAg and undetectable HBV DNA at the end of treatment (EOT). Patients with cirrhosis or malignancy were excluded. CR was defined as serum alanine aminotransferase > two times the upper limit of normal with recurrent viremia. We applied time-dependent Cox proportional hazard models to clarify the association between HBcrAg levels and subsequent CR. Results: The cohort included 203 patients (median age, 49.8 years; 76.8% male; 60.6% entecavir) who had been treated for a median of 36.9 months (interquartile range [IQR], 36.5–40.1). During a median post-treatment follow-up of 31.7 months (IQR, 16.7–67.1), CR occurred in 104 patients with a 5-year cumulative incidence of 54.8% (95% confidence interval [CI], 47.1–62.4%). Time-varying HBcrAg level was a significant risk factor for subsequent CR (adjusted hazard ratio [aHR], 1.53 per log U/mL; 95% CI, 1.12–2.08) with adjustment for EOT HBsAg, EOT anti-HBe, EOT HBcrAg and time-varying HBsAg. During follow-up, HBcrAg <1,000 U/mL predicted a lower risk of CR (aHR, 0.41; 95% CI, 0.21–0.81). Conclusions Dynamic measurement of HBcrAg after NA cessation is predictive of subsequent CR and may be useful to guide post-treatment monitoring.

Objectives: The purposes of this study were to determine whether men and women differ in risk factors for acute myocardial infarction (AMI) during the four seasons of the year. Materials and methods: Medical records of 2,086 (women: 693) patients hospitalized with a confirmed AMI were reviewed retrospectively from the region’s only medical center in eastern Taiwan. The onset date of 544 patients (women: 178) was in spring, 493 patients (women: 165) in summer, 474 patients (women: 155) in autumn, and 575 patients (women: 195) in winter. Risk factors of age, percentage of smoking (smoking%), percentage of diabetes (diabetes%), percentage of hypertension (hypertension%), total cholesterol, and body mass index were assessed. In each season, logistic regression model was used to calculate the odds ratio (OR) and 95% conference interval (CI) of women compared to men by risk factors. Results: In spring, women presented significantly higher values in age (OR 1.022; 95%CI 1.012-1.031 ) and diabetes% (OR2.373；95%CI 1.554-3.625), significantly lower in smoking% (OR 0.187；95%CI 0.145-0.240). In summer, women presented significantly lower values in body mass index (OR 0.907；95%CI 0.856-0.960) and smoking% (OR 0.222; 95%CI 0.134-0.367). In autumn, women presented significantly higher values in age (OR 1.033；95%CI 1.012-1.053) and total cholesterol (OR 1.009；95%CI 1.004-1.013), significantly lower in smoking% (OR 0.168；95%CI 0.098-0.289). In winter, women presented significantly higher values in diabetes% (OR 1.845；95%CI 1.250-2.725), hypertension% (OR1.550；95%CI 1.001-2.402), and total cholesterol (OR 1.008；95%CI 1.004-1.012), significantly lower in smoking% (OR 0.188；95%CI 0.119-0.297). Conclusion: The differences between women and men in risk factors for AMI did present seasonal variation in eastern Taiwan. This finding would provide further insight into medical climatology in preventing serious cardiovascular events.